Subretinal Hemorrhage Associated With Scleral Buckle Surgery for Retinal Detachment: A Consecutive Case Series

This study aimed to analyze rates of subretinal hemorrhage (SRH), any correlations between SRH and drainage technique (scleral cutdown and external needle drainage) during scleral buckle (SB) surgery, as well as associated structural outcomes.

A retrospective analysis was conducted on 351 adult patients undergoing SB surgery, of whom 196 (56%) received SRF drainage, 124 via scleral cutdown and 72 via needle drainage. Data extracted included SRF drainage technique, SRH characteristics, and need for additional surgery.

Intraoperative SRH occurred in 19/196 (9.7%) cases, with no significant difference between techniques (P = 0.99). Macular involvement of SRH was observed in 7/19 (37%) cases; all were macula-off preoperatively. SRH size (P = 0.230), resolution time (P = 0.097), and surgeon variability (P > 0.05) were not significantly different based on drainage technique in this relatively small study. Additional surgery occurred in three cases (1.5%). Average best-corrected visual acuity improved from 20/100 to 20/63 at final follow-up.

Intraoperative SRH rate was 9.7% and not dependent on surgical technique. Most cases had favorable outcomes and only 1.5% of eyes required further surgical intervention. The overall rate of macula-involving SRH was 3.6% and found only in preoperative macula-off detachments. While significant differences between surgical techniques were not seen, larger studies are required to draw more definitive conclusions.