Buckling For Rhegmatogenous Retinal Detachment Research Articles

The necessity and role of scleral buckling for rhegmatogenous retinal detachment.

With a decline in the use of scleral buckling for rhegmatogenous retinal detachment (RRD) repair in recent years, this review seeks to provide a summary of the most recent research findings regarding the role of scleral buckling in the repair of RRD. Many recent studies have compared visual and anatomic outcomes between scleral buckling and pars plana vitrectomy (PPV) for RRD repair. Some suggest superior outcomes with primary scleral buckling, particularly in younger, phakic patients, and in association with other risk factors that we review. Children do best with primary scleral buckling surgery. Functionally, scleral buckling may also result in lower rates of retinal displacement compared to PPV. When PPV is necessary, a supplemental buckle may benefit certain patients, while the advantage remains unclear in other clinical scenarios and necessitates further investigation. Scleral buckling is an important technique for the repair of RRD and it is crucial to continue training retina surgeons in this technique to maximize patient outcomes.

Macular hole following scleral buckling for rhegmatogenous retinal detachment: a case series

BackgroundMacular hole (MH) development following scleral buckling (SB) surgery for rhegmatogenous retinal detachment (RRD) repair is rare. This study presents both full-thickness MH (FTMH) and lamellar MH (LMH) cases following SB for the treatment of RRD.MethodsClinical records of patients undergoing SB surgery for treatment of RRD at the Xi’an People’s Hospital (Xi’an Fourth Hospital) from January 2016 to December 2021 were reviewed, and cases with postoperative MH were selected. Clinical features and follow-up data were summarised, and possible causes were analysed.ResultsAmong 483 identified cases (483 eyes), four eyes (three male patients, one female patient) had postoperative MH, with prevalence, mean age, and mean axial length of 0.83%, 43.5 ± 10.66 years, and 29.13 ± 3.80 mm, respectively. All patients did not undergo subretinal fluid (SRF) drainage. The mean time for detecting MH was 26 ± 15.5 days postoperatively. Macula-off RRD with high myopia and FTMH combined with retinal re-detachment were diagnosed in three patients. One patient had macula-on RRD with outer LMH. The average follow-up duration was 7.25 ± 1.5 months. The FTMH closed successfully after reoperation, while the outer LMH closed without intervention. Visual acuity insignificantly improved or slightly decreased in all patients.ConclusionsPatients with high myopia combined with macula-off RRD might be more susceptible to FTMH, causing MH related retinal detachment. Additionally, LMH following SB was noted in patients with macula-on RRD. Therefore, we should raise awareness of MH following SB for RRD repair.

Efficacy and visual outcomes of the foldable capsular buckle scleral buckling in rhegmatogenous retinal detachment.

To investigate the difference in the effectiveness and refraction of the foldable capsular buckle (FCB) in rhegmatogenous retinal detachment (RRD). Six patients with simple RRD were treated for FCB scleral buckling at Xiamen Eye Center of Xiamen University from October 2023 to February 2024. The parameters assessed included demographic data, clinical data such as preoperative ocular axis, corneal endothelial count, macular foveal thickness, operative time, preoperative and final follow-up intro ocular pressure (IOP), retinal attachment status, and postoperative complications. Refractive change before and after surgery, including sphere, cylinder degree, spherical equivalent, and absolute spherical equivalent difference were compared. All six patients with sound retinal reattachment after FCB scleral buckling, including two men and four women, mean age 41.33 ± 12.40 years old, duration before surgery onset to 7.17 ± 7.16 days, FCB mean operation time 36.67 ± 13.07 min, Preoperative IOP mean 13.35 ± 2.64 mmHg and mean 21.12 ± 8.09 mmHg of final follow-up IOP; there was no significant difference between preoperative IOP and follow-up IOP (p = 0.050). The preoperative sphere range was -6.25 to +2.50 D, and the cylinder range was -2.50 to +1.00 D; the absolute spherical equivalent difference before and after was 1.60 ± 1.69 degrees. FCB can achieve retinal reattachment and restore visual function in cases of RRD. The shorter duration of external scleral buckle compression with FCB suggests that FCB scleral buckling holds greater promise in the clinical treatment of RRD caused by retinal tears.

Risk factors for failure after primary vitrectomy with no scleral buckling for rhegmatogenous retinal detachment

Risk factors for failure after primary vitrectomy with no scleral buckling for rhegmatogenous retinal detachment

Risk factors for surgical failure after primary scleral buckling for rhegmatogenous retinal detachment

ObjectifReconnaître les facteurs de risque d’échec de la chirurgie par plissement scléral (PS) réalisée en vue de réparer un décollement de rétine rhegmatogène (DRR) primaire. NatureÉtude rétrospective de cas consécutifs dans un seul établissement. ParticipantsTous les patients qui ont subi un PS en vue de réparer un DRR primaire au Wills Eye Hospital entre le 1er janvier 2015 et le 31 décembre 2018 ont été inclus. MéthodesOn a évalué le taux de réussite anatomique d'une intervention chirurgicale unique (SSAS) et les facteurs de risque associés à un échec de l'intervention. Une analyse de régression logistique multivariée a été réalisée pour mesurer l'effet des variables démographiques, cliniques et peropératoires sur le taux de SSAS. RésultatsAu total, 499 yeux de 499 patients ont été inclus dans notre étude. Le taux global de SSAS se chiffrait à 86 % (n = 430 sur 499). Selon l'analyse multivariée, la chirurgie était plus susceptible d’échouer chez les hommes (rapport de cotes ajusté [RC ajusté] = 2,98; intervalle de confiance [IC] à 95 % = 1,58–5,62; p = 0,0007), en présence d'une macula soulevée lors de l'examen préopératoire (RC ajusté = 2,15; IC à 95 % = 1,10–4,20; p = 0,03) et en présence d'une vitréorétinopathie proliférante préopératoire (RC ajusté = 4,26; IC à 95 % = 1,10–16,5; p = 0,04). Le temps qui s'est écoulé entre l'examen initial et l'intervention (p = 0,26), le type de plissement ou de matériau utilisé pour réaliser le plissement (p = 0,88) et le recours à la tamponnade (p = 0,74) ne différaient pas de manière significative, que l'intervention ait réussi ou non. ConclusionLe sexe masculin de même que la présence d'une macula soulevée et d'une vitréorétinopathie proliférante préopératoires accroissaient les risques d’échec du PS réalisé en vue de réparer un DRR primaire. Les caractéristiques peropératoires, comme le type de matériau utilisé pour réaliser le plissement de même que le recours à la tamponnade, n’étaient pas associées à un échec de la chirurgie.

SPONTANEOUS REATTACHMENT OF RHEGMATOGENOUS RETINAL DETACHMENT

To describe the clinical characteristics and posterior vitreous findings of spontaneous reattachment of rhegmatogenous retinal detachment (SRRRD). Eighty-six eyes from 80 patients who were diagnosed with SRRRD (SRRRD group) and 92 eyes from 92 patients who had undergone successful scleral buckling for rhegmatogenous retinal detachment ( group for comparison) were included. Ultrawide field fundus imaging and spectral domain optical coherence tomography were performed to evaluate fundus characteristics and vitreoretinal interface. A significant difference was found in the proportion of complete posterior vitreous attachment between the SRRRD and rhegmatogenous retinal detachment groups (44.2% vs. 19.6%, P < 0.001). The incidence of atypical epiretinal tissue (AET) in the SRRRD group was 14% (12 of 86 eyes), whereas none of the eyes in the rhegmatogenous retinal detachment group exhibited AET. In SRRRD eyes with AET, the visual acuity was lower (logarithm of the minimum angle of resolution, 0.51 ± 0.57 vs. 0.14 ± 0.15, P < 0.001), the mean age was higher (years, 61.7 vs. 39.4, P < 0.001), and the SRRRD lesion extent was wider (clock hours, 5.67 vs. 3.70, P = 0.004) than in SRRRD eyes without AET. Compared with the rhegmatogenous retinal detachment group, the SRRRD group had a higher incidence of posterior vitreous attachment. Furthermore, AET was a significant comorbidity in the eyes with SRRRD, particularly in the elderly and the area of presumed reattachment over two quadrants and was related to worse functional outcomes.

Microvascular Changes after Scleral Buckling for Rhegmatogenous Retinal Detachment: An Optical Coherence Tomography Angiography Study.

This retrospective study aimed to investigate macular microvascular alterations after successful scleral buckling (SB) for rhegmatogenous retinal detachment (RRD). Nineteen eyes with macula-on RRD and 18 eyes with macula-off RRD were included. In all cases, an encircling band was placed. Optical coherence tomography angiography (OCTA) was performed at baseline and postoperatively. Changes in the foveal avascular zone (FAZ) area and vessel density (VD) of the superficial capillary plexus (SCP) and deep capillary plexus (DCP) were the primary outcomes. Correlations between OCTA findings and clinical variables were considered secondary outcomes. In both the macula-on and macula-off groups, the FAZ area was comparable with controls. In the macula-on group, VD in the whole SCP was lower compared with controls at both baseline (p &lt; 0.001) and 6 months (p = 0.03), but showed a significant increase after surgery (p = 0.004). In the macula-off group, postoperative VD in both whole SCP and whole DCP was lower compared with controls (p &lt; 0.001). In the macula-on group, there was an inverse correlation between axial length increase and SCP VD change (r = -0.508; p = 0.03). These findings demonstrated microvascular alterations after SB for RRD. However, VD impairment seems to be mitigated after surgery. A greater increase in postoperative axial length was associated with a poorer VD outcome.

A hybrid 26G needle drainage technique in scleral buckling: A mini scleral cut-down.

To evaluate the efficacy and safety of hybrid 26-gauge needle drainage in scleral buckling for rhegmatogenous retinal detachment (RRD). In this retrospective study, we included patients who underwent scleral buckling surgery along with subretinal fluid (SRF) drainage using the 'Hybrid 26G needle drainage technique'. Pre-operative assessment included the best corrected visual acuity (BCVA), lens status, and extent of retinal detachment. Intra-operative surgical details such as the height of retinal detachment, number of attempts required to drain the fluid, amount of fluid drained, adequacy of break buckle relationship, and any intra-operative or post-operative complications were noted. Post-operatively, the final visual outcome and retina status were assessed at 3 months of follow-up. A total of 10 eyes with primary RRD and proliferative vitreoretinopathy C1 or less were included. Pre-operatively, the mean BCVA was 2.43 ± 1.01 logMAR units, which improved significantly to 0.679 ± 0.45 logMAR units (p value < 0.05) at 3 months of follow-up. Regarding the extent of RRD, five eyes (50%) had a total detachment, two eyes (20%) had a sub-total detachment, and three eyes (30%) had an inferior detachment. Four eyes had shallow detachment, four had a moderate detachment, and two eyes had bullous detachment. Complete drainage of SRF (>75%) was achieved in five patients, and a partial but adequate drainage (50-75%) was achieved in the rest of the five patients. In none of the patients, inadequate or dry tap was encountered. No intra-operative complications were encountered. The retina was attached in eight out of ten eyes at 1 week and at a 1-month follow-up period. Two patients required pars plana vitrectomy for persistent SRF. The retina was attached in all the patients at 3 months of follow-up. The 'Hybrid needle drainage' technique is a safe and effective technique for SRF drainage in scleral buckling surgery.

Long-term changes in ocular rigidity following scleral buckling for rhegmatogenous retinal detachment.

To investigate the long-term effect of scleral buckling on corneal biomechanics and the effect of change of scleral properties on intraocular pressure (IOP) measurements. This is a prospective case series, patients with rhegmatogenous retinal detachment prepared for scleral buckling were included. Goldmann applanation tonometry was used to measure IOP (GAT IOP). Ocular Response Analyzer (ORA) was used to measure corneal hysteresis (CH), corneal resistance factor (CRF), goldmann-corrected IOP (IOPg), and corneal-compensated IOP (IOPcc) preoperatively, and 1, 3, and 6months postoperatively. Thirty-three eyes included in the final analysis, with an average age 38.4 ± 16.2years. CH and CRF decreased significantly at first, third, sixth months post-scleral buckling; however, this effect decreased with time as follows; preoperative: 8.9 ± 1.5 and 8.5 ± 2.1, first month: 6.8 ± 1.6 and 7.1 ± 1.8 (P value = 0.00, 0.002), third month: 7.8 ± 1.5 and 7.6 ± 1.6 (P value = 0.001, 0.008), and sixth month: 7.7 ± 1.3 and 7.6 ± 1.7 (P value = 0.002, 0.055). IOP cc was 19.3 ± 3.6, 17.1 ± 4, and 17.6 ± 2.9 at 1, 3, and 6months, and these readings were significantly higher than GAT (13.6 ± 7.6, 12.4 ± 5.1, and 12.1 ± 2.9, P values = 0.00) and IOPg (14.9 ± 3.6, 13.5 ± 4.1, and 13.9 ± 3.5, P values = 0.00). The change in CH at each visit is correlated with the difference between the IOPcc and GAT measurements. The conventional Goldmann applanation tonometry underestimates post buckle IOP measurements due corneal biomechanics changes. ORA might be an alternative and accurate method of measurement; however, further investigation is warranted.

Choroidal vascular changes after encircling scleral buckling for rhegmatogenous retinal detachment.

There is an ongoing debate on whether encircling scleral buckling (SB) procedure for the treatment of rhegmatogenous retinal detachment (RRD) may cause an impairment in choroidal blood flow. The aim of this study was to compare choroidal vascularity index (CVI) and subfoveal choroidal thickness (CT) between eyes that had undergone encircling SB with unoperated fellow eyes (FEs). Thirty patients treated with encircling SB for unilateral RRD were included. Demographic and clinical characteristics as well as enhanced depth imaging-optical coherence tomography scans were retrospectively collected. Images were binarised using ImageJ software, total choroidal area along with luminal and stromal area (respectively, TCA, LA and SA) were segmented and the CVI was computed as the ratio of LA/TCA. In addition, CT was evaluated. The mean follow-up interval between surgery and examination was 25.5 ± 16.8 months. Choroidal thickness, TCA, LA and SA were significantly increased in the operated eyes compared to FEs (respectively, 271.7 ± 78.0 µm vs. 238.5 ± 83.4, P = 0.001; 1.804 ± 0.491 mm2 vs. 1.616 ± 0.496, P = 0.001; 1.199 ± 0.333 mm2 vs. 1.067 ± 0.337, P < 0.001 and 0.605 ± 0.171 mm2 vs. 0.550 ± 0.171, P = 0.001). Conversely, CVI did not significantly differ between the two groups (66.4 ± 3.6 vs. 65.9 ± 3.2, P = 0.490). In conclusion, eyes treated with encircling SB for RRD presented increased LA, SA and CT compared with FEs, but showed no difference in CVI.

Anatomical and functional outcome of scleral buckling in primary rhegmatogenous retinal detachment

Purpose: To study the anatomical and functional outcomes, complications and reasons for failure of scleral buckling in primary rhegmatogenous retinal detachment Design: Prospective Observational Study Materials and Methods: 17 eyes of 16 consecutive patients who had undergone scleral buckling for rhegmatogenous retinal detachment at a tertiary care teaching Ophthalmic Institute in South India from January 2015 were taken up for the study. Important points like history of trauma, spectacle use and cataract surgery were noted from the history. Detailed evaluation including snellen visual acuity converted to Logmar vision, Slit Lamp Evaluation, Fundus examination, Applanation tonometry etc were done and documented before surgery and the same parameters were again noted during the follow up examinations on the first post operative day and then at 2 weeks, 4 weeks, 3months and 6 months. Surgical parameters like number and location of breaks, macular status, type of buckling etc were also recorded diligently. Results: 15 Out of the 17 eyes (88%) achieved anatomical success with the retina attached at 4 weeks of post operative follow up. The cause of failure in the remaining 2 cases was missed retinal breaks and were rescued by vitrectomy. The mean average pre operative vision was 2.23 which improved to a mean average vision of 1.49, 1.30, 1.15, 1.04, 1.01 at 1st post operative day, 2weeks, 4 weeks, 3months and 6 months respectively. The change was found to be significant. The macula on RRDs (4 eyes) had better visual improvement with mean pre op Logmar vision improving from 0.842 to a post op Logmar vision of 0.37 and 0.15 at 4 weeks and 6 months respectively. Conclusions: Scleral buckling provides a reasonably good anatomical outcome in properly selected cases of primary rhegmatogenous retinal detachment. It also provides a moderate visual outcome. The post operative visual outcome depends mainly on the pre operative status of macula. The main cause for failure of sclera

Vitrectomy combined with scleral buckling for rhegmatogenous retinal detachment associated with choroidal detachment

Vitrectomy combined with scleral buckling for rhegmatogenous retinal detachment associated with choroidal detachment

Affecting factors of the efficacy of scleral buckling for rhegmatogenous retinal detachment

Objective To investigate affecting factors of the efficacy of scleral buckling surgery for the treatment of primary rhegmatogenous retinal detachment. Methods The data of 43 eyes of 43 patients with primary rhegmatogenous retinal detachment treated with scleral buckling from Apr. 2015 to Aug. 2018 were retrospectively reviewed. The affecting factors of the efficacy were analyzed. Results There were 38 eyes (88.4%) with a single tear before surgery. The rate of retina reattachment was 86.0%. The preoperative visual acuity and the number of retinal tears were closely related to the retinal reattachment rate (P=0.006, 0.002). The difference in visual acuity of successful retinal reattachment patients at 3 months after operation was statistically significant according to the duration of symptoms (P=0.046). Conclusion Postoperative anatomical reattachment is best achieved in cases with good preoperative visual acuity and less retinal tears. Key words: Retinal, detachment, rhegmatogenous; Buckling, scleral

Efficacy of vitrectomy combined with scleral buckling for rhegmatogenous retinal detachment with vitreous hemorrhage

Objective To evaluate the efficacy of pars plana vitrectomy (PPV) combined with minimal segmental scleral buckling (MSSB) without inert gas or silicone oil tamponade for the treatment of rhegmatogenous retinal detachment (RRD) with vitreous hemorrhage. Methods The data of 99 eyes of 99 cases with RRD with vitreous hemorrhage underwent PPV combined with MSSB from Mar. 2010 to May 2015 were collected and analyzed retrospectively. Results All eyes were localized no-proliferative RRD including 67 eyes with trauma history. The tears placed peripheral retina within a quadrant. Retinal tears were inferior in 73 eyes(73.74%). During operation, 21 eyes (21.21%) underwent air tamponade and 78 eyes (78.79%) received perfusate tamponade. The retinal reattachment rate of the first surgery was 92.93%. The final retinal reattachment rate was 100.00%. The postoperative visual acuity was improved (χ2=68.561, P=0.000). At the end of follow-up, the mean IOP increased from (14.55±3.81) mmHg (1 mmHg=0.133 kPa) to (17.92±2.45) mmHg (t=4.315, P=0.000). However, the IOP were in the normal range. No severe complication occurred during or after surgery. Conclusion PPV combined with MSSB without inert gas or silicone oil tamponade for the treatment of RRD with vitreous hemorrhage has high retinal reattachment rate and few complications. Key words: Vitrectomy, pars plana; Scleral buckling; Retinal detachment, rhegmatogenous

Intraocular currents, Bernoulli's principle and non-drainage scleral buckling for rhegmatogenous retinal detachment.

For many years, it is not fully understood how non-drainage scleral buckling surgery brings about spontaneous reattachment of the detached retina when retinal breaks remain open at the end of surgery. Various explanations have been put forward, but none more interesting than the effect of fluid currents associated with eye movements. One such explanation involved the physics of the Bernoulli's principle. Daniel Bernoulli was an eighteenth century Swiss mathematician and he described an equation based on the conservation of energy. The sum of pressure energy, potential energy and kinetic energy remains constant. Bernoulli's equation usually applies to closed system such as the flow of fluid through pipes. When fluid flows through a constriction, the speed of fluid increases, the kinetic energy increases. If there was no change in elevation (potential energy), then the increase in kinetic energy must be accompanied by a decrease in pressure energy. In ophthalmic surgery, the Bernoulli's effect is the basis for venturi pumps that drive vitrectomy and phacoemulsification machines. This essay expounds on how Bernoulli's effect might be relevant to scleral buckling for retinal detachment repair. In the era when vitrectomy is increasing the primary surgical operation for retinal detachment, the pervasive advice is to emphasise the importance of patient adopting head posture and remaining still postoperatively. The exception is non-drainage scleral buckling surgery. Early postoperative mobilisation may be vital to achieve reattachment.

Comparison between the scleral buckling under wide-angle viewing systems and conventional scleral buckling for the treatment of rhegmatogenous retinal detachment

Objective To compare the efficacy between the scleral buckling under wide-angle viewing systems (WAVS) and conventional scleral buckling for rhegmatogenous retinal detachment. Methods The data of 108 eyes of 108 patients with rhegmatogenous retinal detachment was collected and retrospectively analyzed. All cases were randowly divided into two groups: 54 eyes underwent scleral buckling under WAVS (Group A), and 54 eyes underwent conventional scleral buckling under indirect ophthalmoscope (Group B). Preoperatively, the difference were not statistically significant between the two groups in age, gender, course of disease, best corrected visual acuities (BCVA), IOP, refractive error, the extent of retinal detachment, with or without macular detachment, subretinal demarcation line and the number of retinal breaks. The follow-up period was 12 months. Results Durations of operation, primary operative success rate, BCVA and complications were compared between the two groups. The durations of operation in Group A (with or without encircling operation) were obviously shorter than those in Group B (t=-12.735, -18.037; P=0.000, 0.000). The primary operative success rate was 94.44% in Group A and 92.59 %in Group B, the difference was not statistically significant (χ2=0.026, P=0.917). The BCVA in Group A was better than that in Group B (P<0.001) at 1 month after surgery. However, the difference was not statistically significant between the two groups at 3 (t=-1.202, P=0.214), 6 (t=-0.084, P=0.657), and 12 monthes (t=-1.216, P=0.355) follow-up visits respectively. Conclusion The efficacy of scleral buckling under WAVS is good with shorter operative time. It may be an alternative choose for rhegmatogenous retinal detachment. Key words: Retinal detachment, rhegmatogenous; Scleral buckling; Wide-angle viewing systems

Scleral Buckling for Rhegmatogenous Retinal Detachment Associated with Pars Planitis.

Purpose. To evaluate the surgical outcome of scleral buckling (SB) in rhegmatogenous retinal detachment (RRD) patients associated with pars planitis. Methods. Retrospective review of RRD patients (32 eyes of pars planitis RRD and 180 eyes of primary RRD) who underwent SB. We compared primary and final anatomical success rates and visual outcomes between two groups. Results. Primary and final anatomical success were achieved in 25 (78.1%) and 31 (96.8%) eyes in the pars planitis RRD group and in 167 eyes (92.7%) and 176 eyes (97.7%) in primary RRD group, respectively. Both groups showed significant visual improvement (p < 0.001) and there were no significant differences in final visual acuity. Pars planitis RRD group was associated with higher rate of postoperative proliferative vitreoretinopathy (PVR) development (12.5% versus 2.8%, p = 0.031). Pars planitis and high myopia were significant preoperative risk factors and pseudophakia was borderline risk for primary anatomical failure after adjusting for various clinical factors. Conclusions. Pars planitis associated RRD showed inferior primary anatomical outcome after SB due to postoperative PVR development. However, final anatomical and visual outcomes were favorable. RRD cases associated with pars planitis, high myopia, and pseudophakia might benefit from different surgical approaches, such as combined vitrectomy and SB.

Multiple scleral buckling for rhegmatogenous retinal detachment with multiple tears

Objective To evaluate the efficacy of multiple scleral buckling for rhegmatogenous retinal detachment with multiple tears.Methods Retrospective study on 40 cases (40 eyes) of rhegmatogenous retinal detachment with multiple tears who were treated by scleral buckling.The retinal reattachment and visual acuity were observed.Results In 40 cases,34 cases were reattached successfully and 6 cases failed to be reattach well.Among these 6 cases,3 cases were reattached after adjustment and the other 3 cases were reattached by vitrectomy.Visual acuities were improved in all cases at varying degrees.Conclusion Scleral multiple buckling can treat rhegmatogenous retinal detachment with multiple tears effectively. Key words: Detachment, retinal, multi-tear; Tear, multiple; Buckling, scleral, multiple

Modified Scleral Buckling Technique Using Endoillumination and Non Contact Wide Angle Viewing System

Purpose: To assess feasibility and surgical outcome of a new scleral buckling technique for rhegmatogenous retinal detachment using endo illumination and noncontact wide angle viewing system.Material and Methods: Eleven eyes of 11 patients underwent modified scleral buckling for rhegmatogenous retinal detachment. A custom modified 23 G endo illuminator and noncontact wide angle viewing system was utilized instead of binocular indirect ophthalmoscope to visualize fundus intra operatively.Results: The mean age of patients was 45.3 years. Out of 11 patients, 9 patients (82%) achieved retinal reattachment while 2 patients had to undergo pars plana vitrectomy with silicone oil tamponade due to development of proliferative vitreoretinopathy. 8 (72%) patients achieved stabilization / improvement in visual acuity. 2 patients had minimal subretinal hemorrhage at the time of subretinal fluid drainage.Conclusion: Combining wide angle viewing system and microsurgery with scleral buckling provides a useful and safe alternative for viewing fundus during retinal reattachment surgery.

Minimal segmengtal buckling for retinal detachment

Objective To assess the surgical results of minimal segmental buckling without drainage in the management of rhegmatogenous retinal detachment.Methods The minimal segmental buckling without drainage was performed on 16 eyes of 16 cases with rhegmatogenous retinal detachment under operating microscope.Follow up was from 1 to 6 months after surgery.The retinal reattachment and visual acuities were observed.Results The retinae of 15 eyes (93.75 ％) were reattached successfully with one single operation.The visual acuities were improved in 15 eyes (93.75％).Conclusion Minimal segmental buckling for rhegmatogenous retinal detachment is safe and effective with few complications and high rate of reattachment. Key words: Detachment, retinal ; Surgery ; Microscope, operating