Visual acuity after segmental buckling and non-drainage: a 15-year follow-up

The question addressed is: how does the postoperative visual acuity in eyes treated with segmental buckling compare over time with the paired fellow eyes?

107 detachments were followed prospectively for 15 years. The eyes were divided into: group I, macula attached (46); group II, macula partially detached (10); group III, macula completely detached (51). Mean preoperative visual acuity was 20/30 in group I, 20/100 in group II, and 20/400 in group III. The operation consisted of segmental buckling without drainage. No eye had cerclage or vitrectomy.

The retina remained attached in 99 eyes during the 15-year follow-up. The mean visual acuity of all patients improved six months postoperatively to 20/40 with a maximum of 20/30 at one year. Thereafter there was a linear decrease in all three groups.

Visual acuity improved during the first year, followed by a linear decrease of 0.07 line/year. The paired eyes decreased similarly in relation to age. There was no real difference in the visual acuity of the operated and unoperated eyes (P = 0.079) during the 15 years of follow-up. Mean visual acuity was 20/40 in the operated eyes of 72 patients who were living after 15 years. These data present a challenge to those surgeons who use techniques that include encircling the eye to review and compare their long-term visual results.