Efficacy of scleral buckling for rhegmatogenous retinal detachment with subretinal proliferation_Chinese Journal of Ocular Fundus Diseases

Authors：

Zhu Li ¹ , Li Hong ² , Hu Cheng ¹ , Huang Zhijian ¹ , Yan Ying ¹ , Ding Qin ¹ ,  Chen Xiao ¹

1. Department of Ophthalmology, Central Theater Command General Hospital, Fundus Laser Clinical Medical Research Center, Wuhan 430070, China;
2. Department of Ophthalmology, The 940th Hospital of Joint Logistics Support Force of Chinese, Lanzhou 730000, China;

Corresponding author：

Chen Xiao, Email: cxfn817@163.com

Keywords：

Scleral buckling; Rhegmatogenous retinal detachment; Subretinal proliferation

DOI：

10.3760/cma.j.cn511434-20220421-00234

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Objective To observe the effect of scleral buckling surgery (SB) in the treatment of rhegmatogenous retinal detachment (RRD) with subretinal hyperplasia (SRP). Methods A retrospective case study. From January 2016 to December 2018, 31 patients with old RRD with SRP who were treated with SB in Department of Ophthalmology, Central Theater Command General Hospital were included in the study. There were 18 males with 20 eyes and 13 females with 15 eyes. Age was (26.5±8.7) years. The course of disease was (12.6±10.3) months. The best corrected visual acuity (BCVA) test was performed using the international standard visual acuity chart, which was converted to logarithm of the minimum angle of resolution (logMAR) visual acuity at the time of recording. Retinal detachment ranges ≤2, ＞2-＜3, ≥3 quadrants were 10 (28.6%, 10/35), 20 (57.1%, 20/35), and 5 (14.3%, 5/35) eyes, respectively. All affected eyes were treated with SB. Among them, 22 eyes (63.0%, 22/35) underwent local Scleral buckling, 11 eyes (31.4%, 11/35) underwent combined encircling buckle, and 2 eyes (5.7%, 2/35) underwent encircling buckle alone. Subretinal fluid drainage was performed in 33 eyes (94.3%, 33/35). The mean follow-up time was 18.2 months. Relevant examinations were performed with the same equipment and methods before operation to observe BCVA and retinal reattachment. Paired sample t test was used to compare logMAR BCVA before and after operation. Results At the last follow-up, retinal reattachment occurred in 32 eyes (91.4%, 32/35) of 35 eyes. The retina did not reset in 3 eyes (8.6%, 3/35). logMAR BCVA of affected eye was 0.67±0.29 (finger counting-1.0). The difference of logMAR BCVA before and after operation was statistically significant (t=5.133, P=0.036). In 35 eyes, visual acuity improved, stabilized and decreased in 19 (54.3%, 19/35), 13 (37.1%, 13/35) and 3 (8.6%, 3/35) eyes, respectively. Ten months after surgery, the silicone tape was exposed and infected 1 eye. After the silicone tape was removed, the infection subsided and the retina was in place. There were no intraocular hemorrhage, vitreoretinal impaction, endophthalmitis and other complications during and after operation. Conclusion SB treatment of RRD with SRP can achieve good retinal reposition and improve visual acuity to some extent.

Citation： Zhu Li, Li Hong, Hu Cheng, Huang Zhijian, Yan Ying, Ding Qin, Chen Xiao. Efficacy of scleral buckling for rhegmatogenous retinal detachment with subretinal proliferation. Chinese Journal of Ocular Fundus Diseases, 2023, 39(12): 974-978. doi: 10.3760/cma.j.cn511434-20220421-00234 Copy

1.	Idrees S, Sridhar J, Kuriyan AE. Proliferative vitreoretinopathy: a review[J]. Int Ophthalmol Clin, 2019, 59(1): 221-240. DOI: 10.2142/biophysico.16.0_248.
2.	Machemer R, Aaberg TM, Freeman HM, et al. An updated classification of retinal detachment with proliferative vitreoretinopathy[J]. Am J Ophthalmol, 1991, 112(2): 159-165. DOI: 10.1016/s0002-9394(14)76695-4.
3.	Yao Y, Jiang L, Wang Z, et al. Scleral buckling procedures for longstanding or chronic rhegmatogenous retinal detachment with subretinal proliferation[J]. Ophthalmology, 2006, 113(5): 821-825. DOI: 10.1016/j.ophtha.2005.12.011.
4.	Ghasemi K, Falavarjani S, Alemzadeh A, et al. Scleral buckling surgery for rhegmatogeous retinal detachment with subretinal proliferation[J]. Eye, 2015, 29(4): 509-514. DOI: 10.1038/eye.2014.341.
5.	Holladay JT. Proper method for caculating average visual acuity[J]. J Refract Surg, 1997, 13(4): 388-391. DOI: 10.3928/1081-597X-19970701-16.
6.	Pastor JC, de la Rúa ER, Martin F. Proliferative vitreoretinopathy: risk factors and pathobiology[J]. Prog Retin Eye Res, 2002, 21(1): 127-144. DOI: 10.1016/s1350-9462(01)00023-4.
7.	Lewis H, Aaberg TM, Abrams GW, et al. Subretinal membranes in proliferative vitreoretinopathy[J]. Ophthalmology, 1989, 96(9): 1403-1414. DOI: 10.1016/s0161-6420(89)32712-6.
8.	Wickham L, HO-Yen GO, Bunce C, et al. Surgical failure following primary retinal detachment surgery by vitrectomy: risk factors and functional outcomes[J]. Br J Ophthalmol, 2011, 95(9): 1234-1238. DOI: 10.1136/bjo.2010.190306.
9.	Smith JM, Ward LT, Townsend JH, et al. Rhegmatogenous retinal detachment in children: clinical factors predictive of successful surgical repair[J]. Ophthalmology, 2019, 126(9): 1263-1270. DOI: 10.1016/j.ophtha.2018.11.001.
10.	田超伟, 朱琦, 王雨生, 等. 巩膜外加压术治疗陈旧性视网膜脱离[J]. 中华眼底病杂志, 2006, 22(1): 36-38. DOI: 10.3760/j.issn:1005-1015.2006.01.010.Tian CW, Zhu Q, Wang YS, et al. Clinical study on the treatment of old retinal detachment by scleral buckling procedure[J]. Chin J Ocul Fundus Dis, 2006, 22(1): 36-38. DOI: 10.3760/j.issn:1005-1015.2006.01.010.
11.	Zhou C, Lin Q, Wang Y, et al. Pneumatic retinopexy combined with scleral buckling in the management of relatively complicated cases of rhegmatogenous retinal detachment: a multicenter, retrospective, observational consecutive case series[J]. Int Med Res, 2018, 46 (1): 316-325. DOI: 10.1177/0300060517724931.
12.	Kang KT, Bang SP, Kim YC. Time course of subretinal proliferation after scleral buckling for rhegmatogenous retinal detachment repair[J]. Semin Ophthalmol, 2019, 34(1): 1-10. DOI: 10.1080/08820538.2018.1544647.
13.	刘大川, 郭丽. 巩膜环扎术在玻璃体视网膜手术中的作用[J]. 中华眼底病杂志, 1999, 15(3): 181-182. DOI: 10.3760/j.issn:1005-1015.1999.03.019.Liu DC, Guo L. The role of scleral cligation in vitreoretinal surgery[J]. Chin J Ocul Fundus Dis, 1999, 15(3): 181-182. DOI: 10.3760/j.issn:1005-1015.1999.03.019.
14.	Zhao X, Huang L, Lyu C, et al. Comparison between releasable scleral buckling and vitrectomy in patients with phakic patients with primary rhegmatogenous retinal detachment[J]. Retina, 2020, 40(1): 33-40. DOI: 10.1097/IAE.0000000000002348.

1. Idrees S, Sridhar J, Kuriyan AE. Proliferative vitreoretinopathy: a review[J]. Int Ophthalmol Clin, 2019, 59(1): 221-240. DOI: 10.2142/biophysico.16.0_248.
2. Machemer R, Aaberg TM, Freeman HM, et al. An updated classification of retinal detachment with proliferative vitreoretinopathy[J]. Am J Ophthalmol, 1991, 112(2): 159-165. DOI: 10.1016/s0002-9394(14)76695-4.
3. Yao Y, Jiang L, Wang Z, et al. Scleral buckling procedures for longstanding or chronic rhegmatogenous retinal detachment with subretinal proliferation[J]. Ophthalmology, 2006, 113(5): 821-825. DOI: 10.1016/j.ophtha.2005.12.011.
4. Ghasemi K, Falavarjani S, Alemzadeh A, et al. Scleral buckling surgery for rhegmatogeous retinal detachment with subretinal proliferation[J]. Eye, 2015, 29(4): 509-514. DOI: 10.1038/eye.2014.341.
5. Holladay JT. Proper method for caculating average visual acuity[J]. J Refract Surg, 1997, 13(4): 388-391. DOI: 10.3928/1081-597X-19970701-16.
6. Pastor JC, de la Rúa ER, Martin F. Proliferative vitreoretinopathy: risk factors and pathobiology[J]. Prog Retin Eye Res, 2002, 21(1): 127-144. DOI: 10.1016/s1350-9462(01)00023-4.
7. Lewis H, Aaberg TM, Abrams GW, et al. Subretinal membranes in proliferative vitreoretinopathy[J]. Ophthalmology, 1989, 96(9): 1403-1414. DOI: 10.1016/s0161-6420(89)32712-6.
8. Wickham L, HO-Yen GO, Bunce C, et al. Surgical failure following primary retinal detachment surgery by vitrectomy: risk factors and functional outcomes[J]. Br J Ophthalmol, 2011, 95(9): 1234-1238. DOI: 10.1136/bjo.2010.190306.
9. Smith JM, Ward LT, Townsend JH, et al. Rhegmatogenous retinal detachment in children: clinical factors predictive of successful surgical repair[J]. Ophthalmology, 2019, 126(9): 1263-1270. DOI: 10.1016/j.ophtha.2018.11.001.
10. 田超伟, 朱琦, 王雨生, 等. 巩膜外加压术治疗陈旧性视网膜脱离[J]. 中华眼底病杂志, 2006, 22(1): 36-38. DOI: 10.3760/j.issn:1005-1015.2006.01.010.Tian CW, Zhu Q, Wang YS, et al. Clinical study on the treatment of old retinal detachment by scleral buckling procedure[J]. Chin J Ocul Fundus Dis, 2006, 22(1): 36-38. DOI: 10.3760/j.issn:1005-1015.2006.01.010.
11. Zhou C, Lin Q, Wang Y, et al. Pneumatic retinopexy combined with scleral buckling in the management of relatively complicated cases of rhegmatogenous retinal detachment: a multicenter, retrospective, observational consecutive case series[J]. Int Med Res, 2018, 46 (1): 316-325. DOI: 10.1177/0300060517724931.
12. Kang KT, Bang SP, Kim YC. Time course of subretinal proliferation after scleral buckling for rhegmatogenous retinal detachment repair[J]. Semin Ophthalmol, 2019, 34(1): 1-10. DOI: 10.1080/08820538.2018.1544647.
13. 刘大川, 郭丽. 巩膜环扎术在玻璃体视网膜手术中的作用[J]. 中华眼底病杂志, 1999, 15(3): 181-182. DOI: 10.3760/j.issn:1005-1015.1999.03.019.Liu DC, Guo L. The role of scleral cligation in vitreoretinal surgery[J]. Chin J Ocul Fundus Dis, 1999, 15(3): 181-182. DOI: 10.3760/j.issn:1005-1015.1999.03.019.
14. Zhao X, Huang L, Lyu C, et al. Comparison between releasable scleral buckling and vitrectomy in patients with phakic patients with primary rhegmatogenous retinal detachment[J]. Retina, 2020, 40(1): 33-40. DOI: 10.1097/IAE.0000000000002348.

Chinese Journal of Ocular Fundus Diseases

Efficacy of scleral buckling for rhegmatogenous retinal detachment with subretinal proliferation

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