Abstract
Background
There is controversy about the most appropriate operating methods for complicated rhegmatogenous retinal detachment (RD) including multiple tears, and surgical techniques may be changed according to the preference of the surgeon. In this retrospective study, we compared the surgical results of conventional buckling surgery and vitrectomy with silicone oil tamponade for rhegmatogenous (RD) with multiple breaks.
Methods
Thirty patients who underwent scleral buckling surgery (group 1) and 22 patients who underwent pars plana vitrectomy with silicone oil tamponade (group 2) as the primary surgery for rhegmatogenous RD with multiple breaks were included in this study. The follow-up period was longer than 6 months after surgery. The anatomical success rates and complications were evaluated for both groups.
Results
Retinal reattachment was achieved in 24 of 30 eyes (80%) in group 1 and in 20 of 22 eyes (90.9%) in group 2 after the initial surgery. In group 1, subretinal hemorrhage developed due to the drainage of subretinal fluid in 2 eyes (6.6%) intraoperatively. Elevated intraocular pressure (3.3%), ocular motility disturbances (13.2%), and proliferative vitreoretinopathy (3.3%) were seen in the postoperative period. In group 2, iatrogenic breaks (7.3%) and lens damage (9.09%) occurred during the operation. Macular pucker (4.5%), postoperative cataract progression (22.7%), ocular hypertension (9.09%) and PVR (9.09%) were noted postoperatively.
Conclusions
Both surgical procedures can achieve favorable and comparable anatomic outcomes in the majority of patients in the treatment of RD with multiple breaks. Intra-and postoperative complications are different in the two procedures.
Similar content being viewed by others
References
Ah-Fat FG, Sharma MC, Majıd MA, McGalliard JN, Wong D (1999) Trends in vitreoretinal surgery at a tertiary referral centre: 1987 to 1996. Br J Ophthalmol 83:396–398
American Academy of Ophthalmology (1996) The repair of rhegmatogenous retinal detachments. Ophthalmology 103:1313–1324
Bonnet M (1988) The development of severe proliferative vitreoretinopathy after retinal detachment surgery. Grade B: a determining risk factor. Graefes Arch Clin Exp Ophthalmol 226:201–205
Burton RL, Cairns JD, Campbell WG, Heriot WJ, Heinze JB (1993) Needle drainage of subretinal fluid. A randomized clinical trial. Retina 13:13–16
de Bustros S, Thompson JT, Michels RG, Enger C, Rice TA, Glaser BM (1988) Nuclear sclerosis after vitrectomy for idiopathic epiretinal membranes. Am J Ophthalmol 105:160–164
el-Asrar AM (1997) Primary vitrectomy for bullous rhegmatogenous retinal detachments due to complex breaks. Br J Ophthalmol 7:322–326
Escoffery RF, Olk RJ, Grand MG, Bonıuk I (1985) Vitrectomy without scleral buckling for primary rhegmatogenous retinal detachment. Am J Ophthalmol 99:275–281
Giard DS, Mimoun G, Karpouzas I, Montefiore G (1994) Clinical risk factors for proliferative viteoretinopathy after retinal detachment surgery. Retina 14:417–424
Hakin KN, Lavin MJ, Leaver PK (1993) Primary vitrectomy for rhegmatogenous retinal detachment. Graefes Arch Clin Exp Ophthalmol 231:344–346
Heimann H, Bornfeld N, Friedrichs W, Helbig H, Kellner U, Korra A, Foerster MH (1996) Primary vitrectomy without scleral buckling for rhegmatogenous retinal detachment. Graefes Arch Clin Exp Ophthalmol 234:561–568
Heimann H, Hellmich M, Bornfeld N, Bartz-Schmidt KU, Hilgers RD, Foerster MH (2001) Scleral buckling versus primary vitrectomy in rhegmatogeneous retinal detachment (SPR Study). Design issues and implications. PR Study Report No.1. Graefes Arch Clin Exp Ophthalmol 239:567–574
Hoerauf H, Roider J, Herboth T, Hager A, Laqua H (1997) Outcome after vitrectomy in rhegmatogenous retinal detachment and dense vitreous opacities. Klin Monatsbl Augenheilkd 211:369–374
Lobes LA, Burton TC (1978) The incidence of macular pucker after retinal detachment surgery. Am J Ophthalmol 85:72–77
Machemer R (1995) Reminescences after 25 years of pars plana vitrectomy. Am J Ophthalmol 119:505–510
Machemer R, Buettner H, Norton EW, Parel JM (1971) Vitrectomy: a pars plana approach. Trans Am Acad Ophthalmol Otolaryngol 75:813–820
Michels RG, Wilkinson CP, Rice TA (1990) Complicated types of retinal detachment. In: Klein EA (ed) Retinal detachment. Mosby, St. Louis, pp 625–760
Miki D, Emi K, Motokura M, Yamanishi S (1999) Survey of surgical indications and results of primary pars plana vitrectomy for rhegmatogenous retinal detachment. Jpn J Ophthalmol 43:120–126
Miki D, Hida T, Hotta K, Shinoda K, Hirakata A (2001) Comparison of scleral buckling and vitrectomy for retinal detachment resulting from flap tears in superior quadrants. Jpn J Ophthalmol 45:187–191
Ogura Y, Kitagawa K, Ogino N (1993) Prospective longitudinal studies on lens changes after vitrectomy—quantitative assessment by fluorophotometry and refractometry. Nippon Ganka Gakkai Zasshi 97:627–631
Oshima Y, Yamanishi S, Sawa M, Motokura M, Harino S, Emi K (2000) Two-year follow-up study comparing primary vitrectomy with scleral buckling for macula-off rhegmatogeneous retinal detachment. Jpn J Ophthalmol 44:538–549
Pastor JC, de la Rua ER, Martin F (2002) Proliferative vitreoretinopathy: risk factors and pathobiology. Prog Retin Eye Res 21:127–144
Raymond GL, Lavin MJ, Dodd CL, McLeod D (1993) Suture needle drainage of subretinal fluid. Br J Ophthalmol 77:428–429
Roider J, Hoerauf H, Hager A, Herboth T, Laqua H (2001) Conventional ablation surgery or primary vitrectomy in complicated retinal holes. Ophthalmologe 98:887–891
Schrader WF, Hamburger G, Lieb B, Hansen LL, Kommerel G (1995) Motility and binocular function after radial episcleral buckle. Klin Monatsbl Augenheilkd 207:224–231
Sewell JJ, Knobloch WH, Eifrig DE (1974) Extraocular muscle imbalance after surgical treatment for retinal detachment. Am J Ophthalmol 78:321–323
Singh AK, Glaser BM, Lemor M, Michels RG (1986) Gravity-dependent distribution of retinal pigment epithelial cells dispersed into the vitreous cavity. Retina 2:77–80
Smiddy WE, Loupe DN, Michels RG, Enger C, Glaser BM, deBustros S (1989) Refractive changes after scleral buckling surgery. Arch Ophthalmol 107:1469–1471
Taner V, Minihan M, Williamson TH (2001) Management of inferior retinal breaks during pars plana vitrectomy for retinal detachment. Br J Ophthalmol 85:480–482
The Retina Society Terminology Commitee (1983) The classification of retinal detachment with proliferative vitreoretinopathy. Ophthalmology 90:121–125
Thompson JT (1989) Kinetics of intraocular gases: disappearance of air, sulfur hexafluoride, and perfluoropropane after pars plana vitrectomy. Arch Ophthalmol 107:687–691
Uemura A, Nakao K (1995) A comparison between scleral buckling procedure and vitrectomy for the management of uncomplicated retinal detachment caused by posterior retinal break. Nippon Ganka Gakkai Zasshi 99:1170–1174
Wong D, Chignell AH, Inglesby DV, Little BC, Franks W (1992) The treatment of bullous rhegmatogeneous retinal detachment. Graefes Arch Clin Exp Ophthalmol 230:218–220
Yoshida A, Feke GT, Gren GJ, Goger DG, Matsuhashi M, Jalkh AE, McMeel JW (1983) Retinal circulatory changes after scleral buckling procedures. Am J Ophthalmol 95:182–188
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Afrashi, F., Erakgun, T., Akkin, C. et al. Conventional buckling surgery or primary vitrectomy with silicone oil tamponade in rhegmatogenous retinal detachment with multiple breaks. Graefe's Arch Clin Exp Ophthalmol 242, 295–300 (2004). https://doi.org/10.1007/s00417-003-0842-2
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00417-003-0842-2