Results of primary buckling procedures indicated with regard to recommendations of the SPR study in cases with rhegmatogenous retinal detachment.

BACKGROUND: It was the aim of this study to analyse the functional gain and anatomical success rate in a long-term observation of patients with rhegmatogenous retinal detachments treated primarily with scleral buckling (SB) indicated on the basis of results published in the SPR study. MATERIAL, PATIENTS AND METHODS: 43 of 200 eyes (21.5 %, 41 patients) with rhegmatogenous retinal detachment were selected for scleral buckling as a primary surgical intervention. 38 patients (93 %) completed 6 months, 35 patients (85 %) 12 months and 26 patients (63 %) 24 months of follow-up. Selection of surgical methods was guided by results from the SPR study. Cases were treated by scleral buckling if the chance of primary success was estimated to be at least 90 %.
RESULTS: Primary retinal attachment was achieved in 42 of 43 eyes (98 %). The retina in one eye without primary success was attached by pp-vitrectomy and gas endotamponade. No further redetachments occurred until month 12. Two eyes developed regional retinal traction in the periphery resulting from mild PVR (1 × after 16 months, 1 × after 35 months). Both were permanently attached after pp vitrectomy. At the end of the follow-up all eyes presented complete retinal attachment. Visual acuity improved from a preoperative level of logMAR 0.39 to 0.19 at month 6, 0.16 at month 12 and 0.11 at month 24 (p < 0.03). Cases with partial or complete foveal detachment reached between month 12 and month 24 the same level of visual acuity than those without foveal involvement (p = 0.57).
CONCLUSIONS: The results of this case series clearly indicate that scleral buckling is still an excellent choice of the treatment for approximately one fourth of all patients with rhegmatogenous retinal detachment and may lead to very good long-term results. © Georg Thieme Verlag KG Stuttgart · New York.