Rhegmatogenous PVR detachment: long-term results after extraocular minimal scleral buckling

Abstract

To present the long-term anatomical and functional results and the dynamics of proliferative vitreoretinopathy (PVR) after precise segmental scleral buckling without drainage, known as extraocular minimal surgery. In a prospective study 172 consecutive rhegmatogenous PVR detachments were included which were operated on between January 1994 and February 1996 at the Department of Ophthalmology, Higher Medical Institute, Plovdiv, Bulgaria, with cryopexy and segmental scleral buckling without drainage. The follow-up ranged between 54 and 79 months (xmacr; 5S years). In 43 eyes was a PVR stage A, in 50 stage B, in 60 stage CP, and in 19 a PVR stage CA. All detachments were studied precisely for retinal breaks pre- and intraoperatively and the breaks tamponaded by a precise buckle. 1. Anatomical results: Complete retinal reattachment in 145 eyes (84 %) after 1 operation and in 148 eyes (86 %) after reoperation, residual tractional detachment with reattached macula in 12 eyes (7 %) and detachment due to progression of PVR in 12 eyes (7 %). 2. Functional results: Postoperative visual acuity ranged between 0.3 and 1.0 in 111 eyes after xmacr; 5S years. 3. Dynamics of PVR: In 113 detachments (65,7 %) PVR regressed completely and in 12 (7 %) it progressed; among these were 8 eyes with preoperative PVR-CA and 4 eyes with PVR-CP. Treatment of PVR detachments with nondrainage and minimal buckling provides good anatomical results with macular reattachment in 93 %, resulting in good long-term visual function. Results were best in detachments with PVR stage A, B and CP.