Pneumatic retinopexy, scleral buckling, and vitrectomy surgery in the management of pseudophakic retinal detachments

Abstract

Background: To review the indications for and results of pneumatic retinopexy, scleral buckling, combined pars plana vitrectomy and scleral buckling surgery, and primary pars plana vitrectomy in the management of pseudophakic retinal detachment. Methods: We retrospectively reviewed a series of 100 pseudophakic retinal detachments in 98 patients who were referred to a tertiary care centre for management over a 3-year period. Results: Forty-one cases were treated with retinopexy procedures; 38 underwent scleral buckling surgery; 19 underwent combined pars plana vitrectomy and scleral buckling procedures; and 2 cases underwent vitrectomy only. Pneumatic retinopexy resulted in primary reattachment in 21 out of 41 cases (51%). Scleral buckling surgery resulted in primary reattachment in 32 out of 38 cases (84%). Combined pars plana vitrectomy and scleral buckling surgery was successful in 18 out of 19 cases (95%), and vitrectomy alone was successful in 2 out of 2 cases (100%). Seventy-three cases were successfully repaired after 1 procedure. In the 27 primary failures, subsequent surgery was successful in 26 cases, with a final reattachment rate of 99%. Seventy-four percent of all cases regained 20/50 or better vision. In the 61 cases of macula-off detachments, 35 (57%) regained 20/50 or better vision. Interpretation: Pseudophakic retinal detachments can be successfully managed with pneumatic retinopexy, scleral buckling, and combined vitrectomy and buckling procedures with good anatomic and visual results.