Morphological and functional outcome of scleral buckling surgery compared to primary vitrectomy in patients with retinal detachment

Miroslav Stamenkovic, Ivan Stefanovic, Ivan Sencanic, Vesna Jaksic, Milka Mavija, Sinisa Babovic
2014 Vojnosanitetski Pregled  
Background/Aim. Among the proposed operative techniques for retinal detachment (RD) the most commonly applied are classical method with scleral buckling and pars plana vitrectomy (PPV). The aim of this paper was to determine which surgical intervention of these two leads to better morphological results in terms of the applied retina and better functional outcomes in terms of visual acuity (VA) of the operated eye in patients with RD. Methods. A retrospective study on the comparative section of
more » ... arative section of the effects of scleral buckling surgery and PPV in uncomplicated rhegmatogenous RD was performed. In a 2-year period 97 patients, i.e. 98 eyes with RD were operated on (68 eyes with scleral buckling surgery vs 30 by PPV). Results. In the group with classically operated detachment, the retina was applied in 52 (76.5%) cases vs 30 (100%) patients in PPV group (p < 0.05). Postoperative VA in logMAR was significantly better in both groups compared to preoperative VA: in the classically operated was 1.89 ± 1.04 preoperatively vs 0.98 ± 0.70 postoperatively, while in the PPV group, preoperative value was 2.56 ± 0.67 vs 1.31 ± 0.74 postoperatively (p = 0.001). Conclusion. PPV in uncomplicated forms of RD gives better anatomical results than scleral buckling surgery. VA was significantly improved in both observed groups, while its mean value was postoperatively better in the group that was operated with the classical method. The reason for this could be due to better VA in baseline in the scleral buckling surgery group. Key words: retinal detachment; scleral buckling; vitrectomy; visual acuty; treatment outcome. Apstrakt Uvod/Cilj. Naj eš e hirurške metode rešavanja ablacije retine su klasi na metoda sa serklažom i pars plana vitrektomija (PPV). Cilj ovog rada bio je da se utvrdi koja od navedenih hirurških tehnika ima bolje morfološke (u smislu naleganja retine) i funkcionalne rezultate (vidna oštrina). Metode. Ova retrospektivna studija sprovedena je tokom dve godine na ukupno 98 o iju kod 97 bolesnika sa regmatogenom ablacijom retine koji su operisani ili klasinom metodom sa serklažom (68 o iju) ili PPV metodom (30 o iju). Rezultati. U grupi bolesnika operisanih klasinom metodom, retina je nalegla kod 52 (76,5%) oka vs 30 (100%) oka operisana PPV (p < 0,05). Postoperativna VA (u logMAR) bila je zna ajno bolja kod obe grupe u odnosu na preoperativne vrednosti: kod klasi ne metode preoperativna VA iznosila je1,89 ± 1,04 vs postoperativno 0,98 ± 0,70. U PPV grupi, preoperativna VA iznosila je 2,56 ± 0,67 vs 1.31 ± 0.74 postoperativno (p = 0.001). Zakljuak. PPV kod nekomplikovanih regmatogenih ablacija retine daje bolje anatomske i morfološke rezultate nego klasi na operacija sa serklažom. Vidna oštrina je postoperativno bila bolja u obe grupe, ali je srednja vrednost vidne oštrine bila bolja u grupi operisanoj klasi nom metodom, verovatno zato što je PPV grupa imala lošiju inicijalnu vidnu oštrinu. Klju ne re i: retina, ablacija; vitrektomija; serklaž vitrektomija; vid, oštrina; le enje, ishod.
doi:10.2298/vsp1410920s pmid:25518270 fatcat:y2g5eaqhnfdxplbtsej54tinxq