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      Combined Pars Plana Vitrectomy and Segmental Scleral Buckle for Rhegmatogenous Retinal Detachment with Inferior Retinal Breaks

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          Abstract

          Purpose

          To describe a variation of the traditional segmental scleral buckle (SB) without an encircling band combined with 23-gauge pars plana vitrectomy (PPV) for the management of rhegmatogenous retinal detachment (RRD) with inferior retinal breaks.

          Patients and Methods

          This is a single-center, retrospective, consecutive review of all RRDs with inferior retinal breaks that were treated with PPV and segmental SB without an encircling band between May 2019 and February 2020.

          Results

          A total of 12 eyes of 12 patients were included in the study. All patients had at least 1 inferior retinal break and more than 2 clock hours of retinal detachment. Eight eyes had RRD with macular involvement at presentation. Seven eyes had a persistent RRD following previous pneumatic retinopexy (C3F8). All eyes were treated by PPV combined with a segmental #510 sponge without an encircling band. Surgery anatomical success was 100%. Mean logMAR visual acuity was 1 (SD 0.6; 20/160) and 0.5 (SD 0.4; 20/60) at 3 months and last follow-ups, respectively. No scleral buckle-related complications were noted over the 4.1 (SD 0.8) month follow-up period.

          Conclusion

          The combined segmental buckling technique is a safe and effective adjunct to PPV in treatment of inferior RRD.

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          Most cited references15

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          Visual acuities "hand motion" and "counting fingers" can be quantified with the freiburg visual acuity test.

          Lutz Hansen, Nicolas Feltgen, Stefan K Schulze … (2006)
          The visual acuity (VA) of patients with very low vision is classified using the semiquantitative scale "counting fingers" (CF), "hand motion" (HM), "light perception" (LP), and "no light perception." More quantitative measures would be desirable, especially for clinical studies. The results of clinical VA measurements, Early Treatment Diabetic Retinopathy Study (ETDRS) charts, and the Freiburg Visual Acuity Test (FrACT) were compared. The FrACT is a computerized visual acuity test that can present very large Landolt C optotypes when necessary. Examined were 100 eyes of 100 patients with various eye diseases (e.g., diabetic retinopathy, ARMD), covering a range of VAs from LP to decimal 0.32. The FrACT optotypes were presented on a 17-inch LCD monitor with random orientation. After extensive training, two ETDRS and FrACT measurements were obtained. The testing distance was 50 or 100 cm. ETDRS and FrACT coincided closely for VA > or = 0.02 (n = 80). ETDRS measures were successfully obtainable down to CF (at 30 cm; test-retest averaged over all patients, coefficient of variation [CV](ETDRS) = 9% +/- 8%), and FrACT provided reproducible measurements down to HM (test-retest CV(FrACT) =12% +/- 11%). For CF (n = 6), both ETDRS and FrACT resulted in a mean VA of 0.014 +/- 0.003 (range, 0.01-0.02). The VA results of FrACT for HM (n = 12) were 0.005 +/- 0.002 (range, 0.003-0.009); the individual values were highly reproducible. No results were obtainable for LP (n = 2). The three acuity procedures concur above a VA of 0.02. The results suggest that the category CF at 30 cm can be replaced by 0.014, using ETDRS or FrACT. Using FrACT, one can even reproducibly quantify VA in the HM-range, yielding a mean VA of 0.005.
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            Pars Plana Vitrectomy Alone for the Management of Pseudophakic Rhegmatogenous Retinal Detachment with Only Inferior Breaks.

            Vicente J Martínez-Castillo, José García-Arumí, Anna Boixadera (2016)
            To report the surgical results of primary pseudophakic rhegmatogenous retinal detachment (RRD) with only inferior retinal breaks (IRBs) repaired by pars plana vitrectomy (PPV) alone and complete drainage of subretinal fluid.
            Article 0 comments Cited 26 times – based on 0 reviews     Review now
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              Pars plana vitrectomy and scleral buckle versus pars plana vitrectomy alone for patients with rhegmatogenous retinal detachment at high risk for proliferative vitreoretinopathy.

              Philip Storey, Rayan Alshareef, Mohammed Khuthaila … (2014)
              To compare using pars plana vitrectomy (PPV) combined with a scleral buckle versus primary vitrectomy alone in patients with rhegmatogenous retinal detachment at high risk for postoperative proliferative vitreoretinopathy (PVR).
              Article 0 comments Cited 22 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Clin Ophthalmol
                Journal ID (iso-abbrev): Clin Ophthalmol
                Journal ID (publisher-id): opth
                Journal ID (pmc): clinop
                Title: Clinical Ophthalmology (Auckland, N.Z.)
                Publisher: Dove
                ISSN (Print): 1177-5467
                ISSN (Electronic): 1177-5483
                Publication date (Electronic): 18 August 2021
                Publication date Collection: 2021
                Volume: 15
                Pages: 3515-3519
                Affiliations
                [1 ]Department of Ophthalmology and Vision Sciences, University of Toronto , Toronto, Ontario, Canada
                [2 ]Department of Ophthalmology, Toronto Western Hospital, University Health Network , Toronto, Ontario, Canada
                [3 ]Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto , Toronto, Ontario, Canada
                Author notes
                Correspondence: Efrem D Mandelcorn Department of Ophthalmology, Toronto Western Hospital, University Health Network , 6E-432, 399 Bathurst St, Toronto, ON, M5T2S8, CanadaTel +1 416 603 5418Fax +1 416 603 5193 Email efrem.mandelcorn@utoronto.ca
                Author information
                http://orcid.org/0000-0002-0927-3086
                Article
                Publisher ID: 321371
                DOI: 10.2147/OPTH.S321371
                PMC ID: 8380623
                PubMed ID: 34434043
                SO-VID: d49ead09-2bdb-4950-8b85-ccf411cae782
                Copyright © © 2021 Arjmand et al.
                License:

                This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

                History
                Date received : 09 June 2021
                Date accepted : 06 August 2021
                Page count
                Figures: 1, Tables: 4, References: 15, Pages: 5
                Categories
                Subject: Original Research

                ScienceOpen disciplines: Ophthalmology & Optometry
                Keywords: retinal breaks,vitreoretinal surgery,outcomes,surgical technique,retina,retrospective study
                Data availability:
                ScienceOpen disciplines: Ophthalmology & Optometry
                Keywords: retinal breaks, vitreoretinal surgery, outcomes, surgical technique, retina, retrospective study

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