RETINAL DISPLACEMENT AFTER RHEGMATOGENOUS RETINAL DETACHMENT REPAIR: Scleral Buckling versus Pars Plana Vitrectomy...

To investigate the retinal displacement and metamorphopsia in patients with primary rhegmatogenous retinal detachment treated with pars plana vitrectomy or scleral buckling.

This is a prospective nonrandomized interventional study. A total of 107 patients were studied over a period of 6 months postoperatively. The vessel printing on the fundus autofluorescence photos and the M-CHART were used to evaluate the retinal displacement and the metamorphopsia, respectively. We also assessed the vision-related quality of life, the postoperative visual acuity, and the optical coherence tomographic findings.

Sixty-five male and 42 female patients were recruited in the study. The mean age was 54.8 years (SD 14.7, range 18-82). The proportion of eyes detected with retinal displacement at 6 months postoperatively was significantly lower in the scleral buckling group (4.3%) than in the pars plana vitrectomy group (30.9%) (26.6% difference, 95% CI 13.1%-40.1%, P < 0.001). The scleral buckling group had significantly lower postoperative vertical and horizontal metamorphopsia (45.5% difference, 95% CI 28.3%-62.7% P < 0.001 and 38.2% difference 95% CI 20.7%-55.7%, P < 0.001, respectively). There was no significant difference between the two study groups regarding the vision-related quality of life (1.19 difference, 95% CI -5.76 to 7.70, P = 0.783) and visual acuity (0.08 difference, 95% CI 0.00-0.17, P = 0.051).

Although scleral buckling is not superior in visual acuity improvement and quality of life, it improves anatomical outcomes with less retinal displacement and functional outcomes with less metamorphopsia.