PPV with scleral buckle superior to PPV alone in children with giant retinal tear detachment

The success of pars plana vitrectomy (PPV) was compared with PPV with scleral buckle (SB) in addressing giant retinal tear (GRT) detachments in children and adults. Results, which include single surgery anatomic success at 6 months and 1 year and best corrected visual acuity, show that pediatric and adult eyes respond differently to the 2 procedures.

Study design

This retrospective cohort study looked at eyes with GRT detachments repaired from 2008 to 2020 with at least 6 months of follow-up from 7 institutions in North and South America, Europe, and Asia. A comparison was made between eyes repaired with pars plana vitrectomy (PPV) versus PPV with scleral buckle (SB).

Outcomes

A comparable number of eyes underwent PPV (n = 101) and PPV/SB (n = 99). Single surgery anatomic success (SSAS) was similar between the 2 groups at 6 months and 1 year (82.2% and 77.2%, respectively, for PPV vs 87.9% and 85.7%, respectively, for PPV/SB). For pediatric cases (<18 years), 1-year SSAS rate was higher for PPV/SB (88.5%) than PPV (56.3%). For children, mean BCVA at 1 year was better in the PPV/SB group than in the PPV group. For adults, no difference was found in BCVA between the 2 groups. Slippage did not appear to be exacerbated by the presence of an SB.

Limitations

The retrospective and the multi-surgeon nature of the study make data extrapolation difficult, especially given the heterogeneity of retinal detachments.

Clinical significance

In children, PPV/SB is superior to PPV for anatomic and functional success at 1 year. In adults, the 2 modalities appear to be comparable.