Surgery of complicated retinal detachment with inferior retinal break

Abstract

Objective To investigate the safety and efficacy of buckled and non-buckled vitrectomy with silicone oil tamponade in the treatment of retinal detachment with inferior breaks (IRB)and proliferative vitreoretinopathy (PVR).To determine whether it is necessary and valuable for perform the adjunctive scleral buckling (SB) during vitrectomy.Methods It was a retrospective case series study.A total of 135 eyes of 134 consecutive patients with IRB and PVR were alternatively assigned to the group underwent PPV and silicone oil combined with SB (PPV+SB,n=75) or the group performed PPV with silicone oil alone (PPV,n=60).Silicone oil was removed 3 months at lowest after surgery.Subjects were followed up for 6 months or more.The outcome and complications of the two surgical procedures were analyzed.Results The primary incidence of reattachment of PPV+SB and PPV alone was 97.3％,86.7％ respectively,making a significant differences (Fisher exact test,P ＜0.05).There was no statistical difference in the first and final anatomic success rate between the two groups,and the best-corrected visual acuity (BCVA) at any time points of the two groups showed no statistical difference either (P ＞0.05).The operative time of PPV group was lower compared with PPV+SB group,but needed more retinectomy and brought more iatrogenic breaks (P ＜0.01).Conclusions Non-buckled PPV is a safe and effective surgery for retinal detachment with IRB and PVR.The assistant SB can improve and enhance primary success rates.Non-buckled PPV can not totally replace buckled PPV. Key words: Retinal detachment; Inferior retinal break; Scleral buckling surgery; Vitrectomy; Proliferative vitreoretinophathy