Retina (Philadelphia, Pa.) · 2025
CLINICAL OUTCOMES OF SCLERAL BUCKLING IN ELDERLY PATIENTS WITH RHEGMATOGENOUS RETINAL DETACHMENT: A Retrospective Cohort Study.
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод пока не подготовлен
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Zhu Xinlei, Xu Mengying, Chen Nan, Lun Lingxiao, Wan Lei
Аннотация
PURPOSE: To evaluate the outcomes of scleral buckling in elderly patients with rhegmatogenous retinal detachment and identify independent predictors of postoperative visual outcomes.
METHODS: This retrospective study included 290 eyes from 278 patients who underwent scleral buckling between 2018 and 2024. Patients aged ≥60 years were defined as the elderly group; those ≤30 years served as controls. Clinical parameters and surgical outcomes were analyzed. Logistic regression was performed in the elderly group to identify predictors of final visual acuity.
RESULTS: In elderly patients, scleral buckling achieved a single-surgery anatomical success (SSAS) rate of 98.23%, with 92.03% showing stable or improved vision. Compared to younger patients, the elderly group had lower rates of postoperative intraocular pressure elevation (7.08% vs. 25.99%, P < 0.001) and subretinal hemorrhage (2.65% vs. 9.60%, P = 0.023) but a higher prevalence of posterior vitreous detachment (PVD; 71.7% vs. 17.5%, P < 0.001), which was associated with break location and rhegmatogenous retinal detachment quadrant ( P < 0.001). In the elderly group, multivariate analysis identified baseline visual acuity, macula-on status, and Grade C proliferative vitreoretinopathy as independent predictors of visual outcomes ( P < 0.05).
CONCLUSION: Scleral buckling remains a safe and effective option for selected elderly rhegmatogenous retinal detachment patients. Proper case selection and timely surgery are essential for achieving favorable outcomes in the vitrectomy era.
METHODS: This retrospective study included 290 eyes from 278 patients who underwent scleral buckling between 2018 and 2024. Patients aged ≥60 years were defined as the elderly group; those ≤30 years served as controls. Clinical parameters and surgical outcomes were analyzed. Logistic regression was performed in the elderly group to identify predictors of final visual acuity.
RESULTS: In elderly patients, scleral buckling achieved a single-surgery anatomical success (SSAS) rate of 98.23%, with 92.03% showing stable or improved vision. Compared to younger patients, the elderly group had lower rates of postoperative intraocular pressure elevation (7.08% vs. 25.99%, P < 0.001) and subretinal hemorrhage (2.65% vs. 9.60%, P = 0.023) but a higher prevalence of posterior vitreous detachment (PVD; 71.7% vs. 17.5%, P < 0.001), which was associated with break location and rhegmatogenous retinal detachment quadrant ( P < 0.001). In the elderly group, multivariate analysis identified baseline visual acuity, macula-on status, and Grade C proliferative vitreoretinopathy as independent predictors of visual outcomes ( P < 0.05).
CONCLUSION: Scleral buckling remains a safe and effective option for selected elderly rhegmatogenous retinal detachment patients. Proper case selection and timely surgery are essential for achieving favorable outcomes in the vitrectomy era.