NONDRAINAGE SCLERAL BUCKLING IN THE MODERN VITRECTOMY ERA

To evaluate outcomes of rhegmatogenous retinal detachment treated with a scleral buckle (SB) without external drainage of subretinal fluid during the modern vitrectomy era.

The records of 107 eyes of 107 patients who underwent treatment with nondrainage SB surgery for primary rhegmatogenous retinal detachment with at least 3 months of follow-up were reviewed.

SB surgery included segmental elements (radial, 44.9%; circumferential, 23.4%) and encircling procedures (31.8%). Most patients (68.2%) were aged younger than 60 years, and most eyes (89.7%) were phakic. Single breaks were present in 53.3% of the eyes. The macula was attached preoperatively in 66 eyes (61.7%). Myopia > 5.5 diopters (35.5%) and lattice degeneration (48.6%) were notable risk factors. Posterior vitreous detachment was present in 37.4% of the eyes. Single surgery retinal reattachment was achieved in 104 eyes; three of these eyes also received pneumatic gas injections postoperatively. Four eyes underwent anatomically successful repeat surgery, including one eye that developed a recurrent rhegmatogenous retinal detachment after release of an encircling element. One eye underwent removal of an exposed SB without sequelae, and one eye developed persistent diplopia treated with prism.

With proper case selection, nondrainage SB remains an excellent surgical procedure for repair of rhegmatogenous retinal detachment in the modern vitrectomy era.