NOV 04, 2010
Retina/Vitreous
This retrospective review evaluated outcomes in284 patients with primary rhegmatogenous retinal detachment who re-detached after initial surgery. Patients were divided into three groups based on initial treatment: scleral buckle procedure (SBP), pars plana vitrectomy (PPV) and combined SBP/PPV. Patients were followed up for a mean of 12 months.
All three procedures had a single operation success rate of more than 82 percent, with SBP having the highest (85.7 percent). Of the patients who experienced detachment recurrence (n=72), those with an initial treatment of SBP required fewer number of secondary operations and silicone oil injections, showed a trend for better visual outcomes, and were less likely to develop dense cataract or to require pars plan lensectomy (phakic patients) than those with initial PPV or PPV/SBP.
The drawbacks of this study included its retrospective nature plus the fact that patients initially treated with SBP were younger and more likely to be phakic compared to the PPV and PPV/SBP groups. The authors recommend additional randomized control trials to ensure a complete lack of selection bias.