Study: Fewer cataracts from scleral buckling vs. vitrectomy for rhegmatogenous retinal detachment

Scleral buckling is associated with a lower rate of postoperative cataract formation compared with primary vitrectomy in phakic eyes with rhegmatogenous retinal detachment, a prospective study found. Because of this, scleral buckling should be considered a primary surgical option in such patients, the authors noted.

Raj Vardhan Azad, MD, and colleagues at the All India Institute of Medical Sciences, New Delhi, compared outcomes between the two procedures in a controlled clinical trial. The study included 61 consecutive phakic eyes with primary rhegmatogenous retinal detachment (RRD) not complicated by proliferative vitreoretinopathy.

The researchers randomly assigned 31 eyes to scleral buckling and 30 eyes to pars plana vitrectomy, according to the study.

At 6 months follow-up, 25 eyes (80.6%) in the scleral buckling group and 24 eyes (80%) in the vitrectomy group achieved primary reattachment.

Both groups also had similar improvements in best corrected visual acuity. At 6 months follow-up, mean BCVA had improved from 1.78 preoperatively to 0.6 in the vitrectomy group and from 1.48 preoperatively to 0.6 in the scleral buckling group, according to the study.

Five eyes (17%) in the vitrectomy group developed cataracts, which was significantly more than in the scleral buckling group (P = .018), the authors noted.

"Although primary vitrectomy can achieve anatomical and functional success rates comparable with those achieved by scleral buckling in uncomplicated forms of phakic RRD, the major drawback of the procedure is the high incidence of postoperative cataract formation," the authors said.

"Scleral buckling should thus be used as the primary surgical modality in the treatment of uncomplicated RRD where the media are sufficiently clear," they said.

The study is published in the August issue of Acta Ophthalmologica Scandinavica.