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To Drain or Not to Drain? The Manchester Buckle Study.

Peter Kiraly1,2,3, Myrta Lippera1,4, Naseer Ally5

  • 1Manchester Royal Eye Hospital, Manchester University Hospitals NHS Foundation Trust, Manchester, UK.

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Summary

External drainage of subretinal fluid during scleral buckle surgery for rhegmatogenous retinal detachment is safe but does not improve anatomical or visual outcomes. Its use should be individualized.

Keywords:
Anatomical successBCVAExternal drainageRhegmatogenous retinal detachmentSSASScleral buckle surgerySingle-surgery anatomical successSubretinal fluid

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Area of Science:

  • Ophthalmology
  • Retinal Surgery

Background:

  • Rhegmatogenous retinal detachment (RRD) is a serious condition requiring surgical intervention.
  • Scleral buckling is a common surgical technique for RRD repair.
  • External drainage of subretinal fluid (SRF) is a debated adjunct procedure.

Purpose of the Study:

  • To evaluate the impact of external SRF drainage on anatomical and visual outcomes in primary scleral buckle surgery for RRD.

Main Methods:

  • Retrospective analysis of 609 primary scleral buckles.
  • Comparison of outcomes between patients with and without external SRF drainage.
  • Assessment of single-surgery anatomical success (SSAS) and best-corrected visual acuity (BCVA).

Main Results:

  • No significant difference in SSAS (86.7% with drainage vs. 83.6% without) or final BCVA between groups.
  • External SRF drainage was not independently associated with improved SSAS or BCVA.
  • Drainage was associated with a small risk of localized subretinal hemorrhage (18.8%).

Conclusions:

  • External SRF drainage during scleral buckling is a safe procedure.
  • It does not offer significant benefits in terms of anatomical or visual recovery.
  • Decision to use external SRF drainage should be based on individual RRD characteristics and surgeon preference.