Clinical Features and Surgical Outcomes of Scleral Buckle Surgery for Primary Rhegmatogenous Retinal Detachment

Abstract

Purpose: Long-term study to evaluate the clinical and surgical outcomes of SB surgery for primary rhegmatogenous retinal detachment (RRD) at a large tertiary eye center. Methods: Non-comparative, retrospective case series of 589 eyes of 569 patients with primary RRD who underwent SB surgery between 2004 and 2022 with median follow-up of 6 months. Main outcome measures were best-corrected visual acuity (BCVA), surgical outcomes, complications, and classification of RRD. Results: At baseline, 447/589 (76.1%), round hole-RRD and 133/589 (22.7%) retinal dialysis-RRD. Overall primary SB success rate was 83.7% for all RD subtypes, with round hole-RD 84.8% and dialysis-RRD 81.2%. Overall, Baseline BCVA was logMAR 0.42 and final logMAR 0.26 (p<0.0001). In macula-OFF RRD, the BCVA significantly improved from 0.79 to 0.48 logMAR (p<0.0001). Macula-ON RRD patients improved from 0.19 to 0.12 logMAR (p=0.014). Binary logistic regression showed registrar surgeon grade (OR 0.09,95% CI 0.01- 0.55), and partial or complete PVD (OR 0.21,95% CI 0.10 – 0.49) associated with reduced odds of primary success. Higher surgical failure associated with low pre-fellowship SB surgeon experience (p=0.024). Conclusion: We report favourable visual and functional outcomes in a large series of SB for primary retinal detachment, mainly for round hole and retinal dialysis RRD patients.

Outcomes of Scleral Buckling in Paediatric Rhegmatogenous Retinal Detachment: The Manchester Buckle Study

“…In our study, 69% of the patients were male, which is slightly lower than previous studies reporting a 70–79.5% [ 2 , 7 , 8 ] male predominance among paediatric RRD patients but higher than the 51–64% [ 2 , 9 ] observed in adult RRD patients. Studies reported that this difference could be attributed to the higher incidence of ocular trauma in boys compared to girls [ 2 , 6 , 7 , 8 ].…”

“…Lower anatomical success rates in these studies could be attributed to the inclusion of younger patients with more severe RRD requiring vitrectomy [ 3 ], while our study included less severe RRD suitable for a primary buckle. The SSAS in adult patients undergoing scleral buckle as the primary procedure is significantly higher, ranging from 84 to 91% [ 9 , 11 , 17 ]. The rates of intraoperative and postoperative complications were similar in our paediatric and adult cohorts (unpublished data).…”

Outcomes of Scleral Buckling in Paediatric Rhegmatogenous Retinal Detachment: The Manchester Buckle Study

“…In our study, 69% of the patients were male, which is slightly lower than previous studies reporting a 70–79.5% [ 2 , 7 , 8 ] male predominance among paediatric RRD patients but higher than the 51–64% [ 2 , 9 ] observed in adult RRD patients. Studies reported that this difference could be attributed to the higher incidence of ocular trauma in boys compared to girls [ 2 , 6 , 7 , 8 ].…”

“…Lower anatomical success rates in these studies could be attributed to the inclusion of younger patients with more severe RRD requiring vitrectomy [ 3 ], while our study included less severe RRD suitable for a primary buckle. The SSAS in adult patients undergoing scleral buckle as the primary procedure is significantly higher, ranging from 84 to 91% [ 9 , 11 , 17 ]. The rates of intraoperative and postoperative complications were similar in our paediatric and adult cohorts (unpublished data).…”

Subretinal Hemorrhage Associated With Scleral Buckle Surgery for Retinal Detachment: A Consecutive Case Series

“…While studies have reported outcomes for each technique separately, very few have compared these drainage techniques in terms of SRH incidence and structural outcomes 4,10–12,16,18–20. Additional data is needed to help guide practice patterns.…”

Outcomes of Scleral Buckling in Paediatric Rhegmatogenous Retinal Detachment: The Manchester Buckle Study

“…In our study, 69% of the patients were male, which is slightly lower than previous studies reporting a 70–79.5% [ 2 , 7 , 8 ] male predominance among paediatric RRD patients but higher than the 51–64% [ 2 , 9 ] observed in adult RRD patients. Studies reported that this difference could be attributed to the higher incidence of ocular trauma in boys compared to girls [ 2 , 6 , 7 , 8 ].…”

“…Lower anatomical success rates in these studies could be attributed to the inclusion of younger patients with more severe RRD requiring vitrectomy [ 3 ], while our study included less severe RRD suitable for a primary buckle. The SSAS in adult patients undergoing scleral buckle as the primary procedure is significantly higher, ranging from 84 to 91% [ 9 , 11 , 17 ]. The rates of intraoperative and postoperative complications were similar in our paediatric and adult cohorts (unpublished data).…”

Subretinal Hemorrhage Associated With Scleral Buckle Surgery for Retinal Detachment: A Consecutive Case Series

“…While studies have reported outcomes for each technique separately, very few have compared these drainage techniques in terms of SRH incidence and structural outcomes 4,10–12,16,18–20. Additional data is needed to help guide practice patterns.…”

Outcomes of Scleral Buckling in Paediatric Rhegmatogenous Retinal Detachment: The Manchester Buckle Study

“…In our study, 69% of the patients were male, which is slightly lower than previous studies reporting a 70–79.5% [ 2 , 7 , 8 ] male predominance among paediatric RRD patients but higher than the 51–64% [ 2 , 9 ] observed in adult RRD patients. Studies reported that this difference could be attributed to the higher incidence of ocular trauma in boys compared to girls [ 2 , 6 , 7 , 8 ].…”

“…Lower anatomical success rates in these studies could be attributed to the inclusion of younger patients with more severe RRD requiring vitrectomy [ 3 ], while our study included less severe RRD suitable for a primary buckle. The SSAS in adult patients undergoing scleral buckle as the primary procedure is significantly higher, ranging from 84 to 91% [ 9 , 11 , 17 ]. The rates of intraoperative and postoperative complications were similar in our paediatric and adult cohorts (unpublished data).…”

Subretinal Hemorrhage Associated With Scleral Buckle Surgery for Retinal Detachment: A Consecutive Case Series

“…While studies have reported outcomes for each technique separately, very few have compared these drainage techniques in terms of SRH incidence and structural outcomes 4,10–12,16,18–20. Additional data is needed to help guide practice patterns.…”