Scleral buckling surgery using multiple radial buckles: A valid option?

PURPOSE: To determine whether radial buckling surgery using two or more radial buckles with or without circumferential silicone tires is still a treatment option for rhegmatogenous retinal detachment (RRD) in the current scenario.

METHODS

Retrospective chart review. Patients with RRD with two or more horse-shoe tears with/without proliferative vitreoretinopathy up to grade C1 who underwent buckling surgery using at least two radial buckle segments without encircling bands or drainage and with at least a 3 year follow up were included in the study. Data collected included demographics, corrected distance visual acuity (CDVA) at baseline and final follow up, details of the examination, surgical procedure(s) and complications noted, if any. Appropriate statistical analysis was done. Statistical significance was set at p < 0.05.

OUTCOME MEASURES: Proportion of patients who had an attached retina at final follow up, improvement in CDVA and complications.

RESULTS

25 patients (25 eyes; 12 males and 13 females; 9 pseudophakic) were included.

MEDIAN AGE: 35.15 ± 8.32 years. Median baseline CDVA: 1.97 ± 1.12 log MAR. Median final CDVA: 0.65 ± 0.37 log MAR (significant improvement). Most common presenting complaint was decreased vision (87.5%). Number of radial buckle segments placed varied between 2 and 4 per eye. One patient required vitrectomy for persistent retinal detachment. One required buckle removal for infection 5 years after the primary procedure. One patient required strabismus surgery.

MEDIAN FOLLOW UP: 12.25 years ± 2.14 years. None of the other patients had any complications.

CONCLUSION

Radial buckling surgery (two or more segments) is a reasonably safe and valid alternative to vitrectomy for RDs with multiple breaks in different planes.