Issue: Vojnosanit Pregl 2017; Vol. 74 (No. 3)

Anatomical and functional factors influencing the results of scleral buckling procedure for macula-off rhegmatogenous retinal detachments

Authors:
Igor Kovačević, Aleksandra Radosavljević, Ivan Stefanović, Bojana Radović, Jelena Karadžić, Dragana Kovačević Pavićević, Olgica Djurković-Djaković

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Background/Aim. Rhegmatogenous retinal detachment is
a potentially blinding condition of the posterior segment of
the eye. Currently, the only treatment modality is surgery
and surgical options include scleral buckling, pars plana
vitrectomy and pneumoretinopexy. Many factors may influence
the outcome of the surgery. Well defined indications
are essential for achieving the best postoperative results.
The aim of this study was to assess anatomical and functional
outcome of treatment with scleral buckling for macula-
off rhegmatogenous retinal detachments. Methods.
This prospective, nonrandomized, interventional study included
consecutive patients underwent scleral buckling for
macula-off retinal detachment in the tertiary centre for vitreoretinal
surgery. Results. A total of 168 consecutive patients
(mean age 58.2 ± 13.9 years) were included in the
study. Postoperatively, anatomical success was achieved in
152 (90.5%) of the patients. Parameters that influenced the
anatomical success included the number of retinal breaks
(p = 0.040), lens status (p = 0.041), preoperative proliferative
vitreoretinopathy (p < 0.001), patients’ age (p = 0.049),
and marginally, the presence of typical symptoms
(p = 0.057). Duration of macular detachment, previous ocular
trauma and refraction of the eye did not affect the anatomical
result. Functional success was evaluated using the
postoperative visual acuity and depended mainly on the duration
of macular detachment prior the surgery. Visual acuity
0.4 or better was significantly more often achieved if duration
of macular detachment was up to seven days
(p < 0.001). Refraction and patients’ age did not influence
the functional result. Conclusion. Scleral buckling is an efficient
surgical procedure for treatment of patients with
retinal detachment. Optimal results are achieved if operation
is performed within the first seven days of duration of
macular detachment.