Absorbable suture for band tightening of scleral buckling in pseudophakic rhegmatogenous retinal detachment: a modified surgical technique and a 6-month follow-up.

Abstract

Rhegmatogenous retinal detachment (RRD) is a separation of the neurosensory retina from the retinal pigment epithelium as a result of liquid vitreous passing through a retinal break. Scleral buckling surgery (SB) is a conventional treatment for RRD. In SB, a silicon explant is used to indent the sclera, reduce vitreous traction, and close the retinal break, and an encircling band is used circumferentially, leading to myopia. This study aimed to evaluate the functional and biometric outcomes after SB with absorbable band-tightening sutures in patients with pseudophakic RRD. In this prospective interventional study, we included pseudophakic eyes with RRD treated surgically with SB and a temporary encircling band using a 6-0 absorbable Vicryl suture to tighten the band, instead of conventional permanent suture tightening. Anterior chamber depth (ACD), axial length (AL), intraocular pressure (IOP), spherical equivalent refractive error (SER), and best-corrected distance visual acuity (BCDVA) were measured preoperatively and at 1 day, 2 weeks, 3 months, and 6 months postoperatively. We included 30 eyes of 30 patients with a mean (standard deviation [SD]) age of 66.1 (10.5) years who underwent SB with an absorbable band-tightening suture for pseudophakic RRD. Significant increases in AL and ACD were observed at 2 weeks after surgery, with a significant decline in values thereafter; however, at the 6-month follow-up, the values were significantly higher than those at baseline (all P < 0.05). Based on the Vicryl tension and its hydrolysis, mean (SD) SER at 2 weeks postoperatively was significantly more myopic than at baseline (-5.8 [1.6] D versus +1.3 [1.8] D). However, the mean (SD) SER decreased significantly throughout the 6-month follow-up (all P < 0.05), and it reached -1.8 (0.9) D, which was comparable with the mean baseline SER (P = 0.140). The participants experienced significant improvement in BCDVA throughout the follow-up period (all P < 0.05). Using an absorbable suture to tighten the encircling band in patients with pseudophakic RRD can reduce postoperative myopia without adversely affecting the anatomical or functional outcomes. Future comparative studies with larger sample sizes and longer postoperative follow-up are needed to verify these findings.