Abstract
Purpose Most studies about retinal detachment cover a limited follow-up period. The purpose of this research is to assess the long-term results after pars plana vitrectomy (PPV) and scleral buckle (SB) surgery in patients with rhegmatogenous retinal detachment (RRD). Methods 155 patients with RRD are treated either with SB or PPV with a mean follow-up of more than 5 years. Retrospective analysis of patient data with RRD was performed between January 2006 and June 2008 at a tertiary eye clinic. Results Overall primary success rate was 85.2% (PPV: 84.6%, SB: 89.5%; p=0.57). 90.5% of redetachments appeared within the first 124 days. No significant different success rate was found for vitrectomy with and without additional encircling band (p=0.09). No advantage of a supplemental encircling band in cases of preoperative inferior breaks was seen (p=0.81). Patients of SB group were treated more frequently in follow-up time because of epiretinal membrane (ERM) (SB: 15.5% versus PPV: 7.3%). No patient of the PPV group without intraoperative use of endolaser cerclage (14.7%) had any peeling surgery postoperatively. Conclusion Redetachment rates of both methods are comparable in a clinical setting where PPV is considered a suitable method for pseudophakic patients and in complex cases and SB was performed in younger phakic patients with clearly identified retinal tears. PPV seems to show a more heterogenous pattern of complications. No advantage of a supplemental encircling band could be found in these case series of patients with primary RRD. No relevant long-term risk of redetachment was seen after SB.
Highlights
Scleral buckling (SB) and pars plana vitrectomy (PPV) have shown similar functional and anatomical results in the treatment of retinal detachment
Pseudophakia was significantly higher represented in the vitrectomy group (n= 61 in PPV group versus n= 1 in SB group, p=0.001)
Another study from Germany which analyzed results of retinal detachment surgery 10 years earlier, namely from 1990-1997, showed a slightly lower primary attachment rate of 71.2% than our study [7].The improvement in surgical results can be accorded to the continuous technical developments that the pars plana vitrectomy method underwent due to its relatively recent invention in the 1970s compared to the older hump technique
Summary
Scleral buckling (SB) and pars plana vitrectomy (PPV) have shown similar functional and anatomical results in the treatment of retinal detachment. Most of the studies only cover a short follow-up period [1,2,3,4,5,6] This retrospective clinical follow-up study is set up to show short- and long-term results and clinical outcome of retinal detachment surgery in a regular setting of a tertiary eye clinic. Both surgical methods should be checked regularly for their applicability and put into context with the real situation. This study was prepared in order to record and analyze the long-term course after a retinal detachment surgery at a time when the vitrectomy seems to displace the hump technique more and more. As the indications of the surgical procedures are in part different as described in the methods sections, no randomization or direct comparison of both methods is warranted
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