Severe proliferative vitreoretinopathy and retinal detachment. II. Surgical results with scleral buckling.

Prior to the era of vitrectomy, scleral buckling was used to treat 521 eyes with total retinal detachment and proliferative vitreoretinopathy (PVR) of various degrees of severity. The retina was reattached for at least six months in 46.9% of eyes; the anatomic success rate decreased with increasing severity of PVR. Within each grade of PVR, the reattachment rate was higher for eyes with smaller breaks than for eyes with larger breaks, and the prognosis was not worse when smaller breaks were found than when no breaks were found. The cumulative success rate rose with increasing number of reoperations. None of the anatomically successful cases had a final visual acuity of no light perception; 82.9% of them achieved a visual acuity of counting fingers or better. The prognosis for visual improvement after successful scleral buckling was unrelated to the preoperative severity of PVR. Severe intraoperative complications occurred in 5.0% of the eyes, all of which resulted in failure.