Encircling scleral buckling for the treatment of retinal detachment: Development in indication and outcome within the last decade

Abstract

Background/Objectives: To evaluate the use of encircling scleral buckling for treating retinal detachment (RD) and its complications as well as success rate within the last decade. Subjects/Methods: This retrospective observational study included 163 eyes receiving encircling scleral buckling (ESB) or ESB combined with vitrectomy (SBV) between 2009 and 2018. Main outcome measures include usage rate of ESB and SBV, indications and mean age. Furthermore, intra-/postoperative complications, intraocular tamponades as well as influences on functional outcome (BCVA) and central retinal thickness (CRT) were evaluated. For statistical analysis, patients were divided into five groups of two years each. Results: ESB and SBV surgeries decreased from initially 32% of all RD-operations between 2009-2010 to 9.2% between 2017-2018 (p<0.001, ANOVA). Mean age at surgery differed significantly over the years from 56.9±17.1 between 2009-2010 to 37.6±28.3 between 2017-2018 (p<0.001, ANOVA). Functional outcome after a mean follow-up time of 43.1±39.5 months increased from 1.34±0.88 logMAR at baseline (BSL) to 0.99±0.87 logMAR at the last follow-up visit. Significant influencing factors on BCVA were BCVA at BSL (p<0.001), duration of RD (p=0.01) and lens status (pseudophakic > phakic > aphakic, p<0.001). Significant impacts on CRT were surgical technique (SBV > ESB, p=0.017) and macula on/off (off > on, p=0.036). Conclusion: After an initial decrease, a rebound in ESB and SBV surgeries was noticed, with a significant reduction in mean age. Indications for surgery shifted over our observational period. No significant differences in functional outcome as well as intra- and postoperative complications were observed.