This article is more than 5 years old. Information may no longer be current.
Scleral buckling should be resumed for its many advantages, surgeon says
Click Here to Manage Email Alerts
 Ali Abri |
VIENNA, Austria — Scleral buckling has been gradually abandoned in favor of pars plana vitrectomy for rhegmatogenous retinal detachment, but surgeons may want to resume it because it gives better results in some cases at a lower cost and with better comfort for the patient.
"Scleral buckling has been the gold standard for 3 decades but is difficult surgery. This is mainly the reason why the younger generation of surgeons has promptly embraced PPV as an alternative, novel procedure, which serves just as well in most cases and is more reproducible and easier to learn," Ali Abri, MD, said at the Advanced Retinal Therapy meeting here.
The trend toward performing pars plana vitrectomy (PPV) as a first-line procedure in retinal detachment was accelerated by small-gauge sutureless surgery, he noted.
The Scleral Buckling versus Primary Vitrectomy in Rhegmatogenous Retinal Detachment Study, which compared the functional and anatomical results of the two techniques, showed an equal success rate in terms of retinal reattachment, but significantly better best corrected visual acuity results were obtained with scleral buckling in phakic eyes.
"There was also a higher rate of cataract operations required with PPV," Dr. Abri said.
In pseudophakic eyes, reattachment at final follow-up was higher in the scleral buckling group.
"Scleral buckling is a cost-effective procedure that does not require expensive equipment. There is no problem with posturing for the patient, less risk of [proliferative vitreoretinopathy], no cataract formation, no risk of endophthalmitis. Advantages are many, but experience is mandatory and is unfortunately increasingly rare in younger surgeons," Dr. Abri said.
- Disclosure: Dr. Abri has no relevant financial disclosures.