Skip to main content

  • PPV Versus PPV Plus Scleral Buckle for RDs

    By Jean Shaw
    Selected by Andrew P. Schachat, MD
    Add to My Bookmarks

    Journal Highlights

    Ophthalmology Retina, July 2022

    Download PDF

    In an international study, Ong et al. set out to determine surgeons’ preferences for treating giant retinal tear–related retinal detachments. They found that pars plana vitrectomy (PPV) and PPV plus scleral buckle (PPV+SB) are equally common and have comparable anatom­ic and visual outcomes among adults. Among children younger than age 18 years, however, PPV+SB was superior to PPV alone at the one-year mark.

    For this retrospective cohort study, the researchers reviewed electronic medical records from seven medical institutions around the world. A total of 195 patients (200 eyes), 42 of whom were children, were included in the study. All told, 101 eyes underwent PPV alone, and 99 underwent PPV+SB. Baseline demographics and ocular characteristics studied did not dif­fer between the two groups except for those patients with a history of developmental abnormalities or who had prior intraocular surgery and were phakic.

    With regard to anatomic outcomes, the overall success rates were similar between the two groups at six and 12 months: 82.2% and 77.2% for PPV alone, respectively, and 87.9% and 85.7% for PPV+SB, respectively. However, when stratified by age, the 12-month success rate was higher for PPV+SB than for PPV alone for chil­dren younger than age 18 (88.5% versus 56.3%; p = 03).

    With regard to visual outcomes, the mean best-corrected visual acuity at baseline did not differ between PPV and PPV+SB groups. Once again, however, when stratified by age, children who underwent PPV+SB had better outcomes at 12-month follow-up than those who underwent PPV alone (p = .001). No such difference was found for adults.

    The mean time to first redetachment was 7.9 months in the PPV group and 5.5 months in the PPV+SB group, with proliferative vitreoretinopathy as the most common cause of redetachment. Postoperative complications were simi­lar between the two groups.

    Overall, these results support the use of PPV+SB in children and PPV alone in adults as an option for treating giant retinal tear–related retinal detachments, the authors said.

    The original article can be found here.