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  • Scleral Buckling has...

Scleral Buckling has no advantage over Pars Plana Vitrectomy in Primary Rhegmatogenous Retinal Detachment Repair: Study

Written By : Dr.Niharika Harsha B |Medically Reviewed By : Dr. Kamal Kant Kohli Published On 2025-01-05T21:45:56+05:30  |  Updated On 6 Jan 2025 12:04 PM IST
Scleral Buckling has no advantage over Pars Plana Vitrectomy in Primary Rhegmatogenous Retinal Detachment Repair: Study
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A recent study published in the journal Clinical Ophthalmology revealed that combining scleral buckling with pars plana vitrectomy has minimal effect and limited success on anatomical outcomes in Rhegmatogenous retinal detachment (RRD) repair.

Rhegmatogenous retinal detachment (RRD) can cause significant and irreversible vision loss if left untreated. Recent literature shows an increased incidence of RRD due to increased myopia and cataract surgeries in younger individuals. Pars plana vitrectomy (PPV) is now the preferred primary surgical technique for RRD repair, with supplemental scleral buckling (SB) used in specific cases to address specific complications. Despite its advantages, SB may increase discomfort, altered refractive errors, and controversial benefits. Hence, to address this, researchers from Chiang Mai University Hospital conducted a study to compare anatomical and visual outcomes of PPV alone versus combined PPV/SB using propensity score analysis to reduce bias.

Also Read: Congenital cataract with persistent fetal vasculature without anterior segment pathology associated with best postoperative visual acuity: Study

A single center retrospective observational study was carried out y including patients who underwent PPV or PPV/SB for RRD repair between January 2013 and December 2019 and were followed up for at least two months. Demographic data, clinical features, surgeries, and outcome data were collected. Th primary outcomes included the single surgery anatomic success (SSAS) and final anatomic success, whereas the secondary outcomes included final visual acuity changes. Categorization was done based on the retinal breaks and surgeon experience, and visual acuity was converted to LogMAR for analysis. Surgical techniques followed standard PPV protocols, with SB added in specific cases.

Findings:

  • About 683 patient-eyes, with a median follow-up duration of 13 months were included in the study.
  • Among these 211 patients (30.9%) underwent PPV/SB, while 472 patients (69.1%) underwent PPV as the primary procedure.
  • There was no significant difference between the two treatment groups in the risk of achieving SSAS or achieving final retinal anatomic attachment.
  • The two treatment groups have shown a similar occurrence of proliferative vitreoretinopathy.
  • However, a significantly greater mean improvement in VA was seen in patients who received PPV alone.
Also Read: Journal Club-Systematic review of surgical techniques for treating giant retinal tears in adults: A current assessment of approaches and interventions

Thus, the study concluded that adding SB to PPV had little impact on anatomical results. There was minimal effect on single surgical success rate and overall final success rate. Even though there was an improvement in vision outcomes, the evidence was not definitive. Researchers also suggested further research through prospective studies and using standardized techniques to improve the reliability of the results.

Further reading: Rajsirisongsri, P., Patikulsila, D.et al. Primary Rhegmatogenous Retinal Detachment Repair by Pars Plana Vitrectomy with and without Scleral Buckling: A Propensity Score Analysis. Clinical Ophthalmology, 18, 3913–3923. https://doi.org/10.2147/OPTH.S494849.

Clinical OphthalmologyophthalmologyPongthep RajsirisongsriPrimary Rhegmatogenous Retinal Detachment RepairPars Plana Vitrectomy
Source : Clinical Ophthalmology
Dr.Niharika Harsha B
Dr.Niharika Harsha B

    BDS, MDS

    Dr.Niharika Harsha B (BDS,MDS) completed her BDS from Govt Dental College, Hyderabad and MDS from Dr.NTR University of health sciences(Now Kaloji Rao University). She has 4 years of private dental practice and worked for 2 years as Consultant Oral Radiologist at a Dental Imaging Centre in Hyderabad. She worked as Research Assistant and scientific writer in the development of Oral Anti cancer screening device with her seniors. She has a deep intriguing wish in writing highly engaging, captivating and informative medical content for a wider audience. She can be contacted at editorial@medicaldialogues.in.

    Dr. Kamal Kant Kohli
    Dr. Kamal Kant Kohli

    Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751

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