Scleral buckling for retinal detachment. Predictors for anatomic failure.

PURPOSE: The influence of various preoperative, intraoperative, and postoperative factors on retinal reattachment after scleral buckling was examined.

METHODS

A study of 601 eyes of 577 consecutive patients who underwent conventional scleral buckling procedures was conducted. Multiple logistic regression analysis was used to determine the independent influence of each variable on anatomic failure.

RESULTS

Anatomic reattachment of the retina was achieved in 86% of eyes after a single procedure, and in 90% of eyes after a second surgical procedure, with a mean follow-up period of 5.27 months (range, 2-29 months). Factors predictive of poor anatomic success (P < 0.05) included preoperative choroidal detachment and significant vitreous opacification; circumferential buckle extent of more than two quadrants and intravitreal injection of air or fluid intraoperatively; and postoperative occurrence of sterile vitritis.

CONCLUSION

Breakdown of the blood-retinal barrier leading to cellular migration and proliferation is considered to be predictive of anatomic failure after scleral buckling procedures.