Abstract
Purpose:To compare the results of narrow encircling band surgery with standard encircling scleral buckling for retinal detachments (RDs) with intrabasal or unseen breaks.Methods:In a retrospective study, eyes with intrabasal or unseen breaks underwent narrow band implantation (group N) or standard encircling buckling plus wide tire placement (group W) and were followed for at least one year.Results:A total of 112 eyes including 39 eyes in group N and 73 eyes in group W were studied. Preoperatively visual acuity of eyes in group N was significantly better (1.55 ± 0.9 vs. 1.93 ± 0.9 logMAR, P = 0.043). The two study groups (N and W) were comparable in terms of the extent of RD (2.8 ± 0.96 vs. 2.8 ± 0.93 quadrants), interval to surgery (88.3 ± 176.4 vs. 71.9 ± 135.4 days) and percentage of visible breaks (56.4% vs. 63%), respectively (all P values > 0.05). More atrophic holes were present in group W and more dialyses were reported in group N. The single operation success rate at 12 months was 69.2% in group N and 74% in group W (P = 0.1). The single operation success rate for eyes with unseen breaks was also comparable (66.7% vs. 85.7%, P = 0.157). Final corrected visual acuity was also similar (0.63 ± 0.44 vs. 0.85 ± 0.69 log MAR). The only factor influencing success rate was the type of retinal breaks (P = 0.04). Type of scleral buckling did not affect the single operation success rate (P = 0.460).Conclusion:Narrow encircling band surgery is a possible option with acceptable single operation success rate for RDs with intrabasal or unseen breaks.
Highlights
Scleral buckling is considered the standard procedure for repairing rhegmatogenous retinal detachments (RRDs).[1]
PPV has recently been proposed as the primary procedure in cases with aphakic and pseudophakic RRD,[2,3,4,5] but the value of scleral buckling has been re‐emphasized in eyes with primary phakic RRD.[6]
Patient data were collected from hospital files and included gender, age, duration of retinal detachment (RD), status of the fellow eye, preoperative visual acuity, intraocular pressure (IOP), relative afferent papillary defect (RAPD), lens status, extent of RD and macular status, type of scleral buckling, intraoperative complications, postoperative visual acuity, retinal and macular reattachment, complications and the need for reoperations
Summary
Scleral buckling is considered the standard procedure for repairing rhegmatogenous retinal detachments (RRDs).[1] PPV has recently been proposed as the primary procedure in cases with aphakic and pseudophakic RRD,[2,3,4,5] but the value of scleral buckling has been re‐emphasized in eyes with primary phakic RRD.[6]. Successful treatment of RRDs needs exact localization and closure of all retinal breaks.[7,8] Despite a thorough examination, retinal breaks can be missed in 3‐14% of primary RRDs.[8] Considering the challenges posed in treating such cases, a number of techniques namely encircling scleral buckling and pars plana vitrectomy. Accepted: 17-05-2014 have been suggested.[8,9,10,11] Primary anatomical success rates of 53‐85% have been reported for RRDs with unseen breaks.[8,12,13]
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