Abstract :
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 scleral buckling was missed retinal breaks. There were no major complications in any of our cases.
Keyword :
Scleral buckling, Rhegmatogenous, Retinal detachment, Break, Macula on, Macula off.