The clinical analysis of scleral buckling for rhegmatogenous retinal detachment of 376 patients_Chinese Journal of Ocular Fundus Diseases

Authors：

 Hu Yuzhang , Chen Yanjun , Liu Hua , Zhou Bo , Liao Ke

Chengdu Aidi Eye Hospital, Chengdu 610072, China;

Corresponding author：

Hu Yuzhang, Email: rsn2008@sina.com

Keywords：

Retinal detachment/surgery; Scleral buckling

DOI：

10.3760/cma.j.cn511434-20200312-00108

Video：

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Objective To analyze the clinical efficacy of scleral buckling surgery for rhegmatogenous retinal detachment (RRD) of 376 patients.Methods A retrospective analysis was performed about 376 patients (391 eyes) who underwent scleral buckling surgery in Chengdu Aidi Eye Hospital from January 2018 to December 2019. There were 214 males (224 eyes) and 162 females (167 eyes). There were 15 binocular cases and 361 monocular cases. The average age was 37.16±16.36 years. The average course of disease was 3 months. There were 1 to more than 10 retina holes for all patients. Retinal breaks occur in all quadrants and at ora serrata. The preoperative average BCVA was 0.27 and the postoperative average BCVA was 0.41. Retinal detachment ranges was observed in 268 eyes in 1 quadrant, 97 eyes in 2-3 quadrants, 26 eyes in total, and 231 eyes with macular involvement. There were 376 eyes treated with scleral buckling, 9 eyes treated with scleral buckling combined with scleral encircling, 6 eyes treated with scleral encircling. The average follow-up time was 5 months. Postoperative follow-up was conducted to observe retinal reduction, BCVA, complications and patient compliance.Results After the first operation, retinal reattachmnents were successfully achieved in 375 eyes (95.91%); 16 eyes (4.09%) failed in retinal reattachmnents. Eight eyes were treated with scleral buckling again, 5 eyes were treated with vitrectomy silicone oil filling, and 3 eyes were treated with air injection. After the second operation, retinal reattachmnents were ultimately achieved in 16 eyes (100.00%). The average BCVA after operation was 0.15. Postoperative intraocular pressure increased by 45 eyes (11.51%). The intraocular pressure increased from the next day to 3 days after operation. The intraocular pressure was completely controlled 1-3 days after the treatment of topical medication and 20% mannitol. Vitreous and subretinal hemorrhage in 1 eye caused by drainage of the subscleral liquid. There was no cases withpostoperative infection.Conclusion The retinal reattachment rate is 95.91% in 376 patients with RRD treated by scleral buckling surgery, and the visual acuity has significantly improved.

Citation： Hu Yuzhang, Chen Yanjun, Liu Hua, Zhou Bo, Liao Ke. The clinical analysis of scleral buckling for rhegmatogenous retinal detachment of 376 patients. Chinese Journal of Ocular Fundus Diseases, 2020, 36(7): 539-543. doi: 10.3760/cma.j.cn511434-20200312-00108 Copy

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7.	李云鹏, 李丹丹, 曾蕊, 等. 手术显微镜下微创巩膜扣带术治疗孔源性视网膜脱离[J]. 中华眼外伤职业眼病杂志, 2018, 40(7): 512-514. DOI: 10.3760/cma.j.issn.2095-1477.2018.07.009.Li YP, Li DD, Zeng R, et al. Minimally invasive scleral buckling surgery under operating microscope for the treatment of rhegmatogenous retinal detachment[J]. Chin J Ophthalmol Vis Sci, 2018, 40(7): 512-514. DOI: 10.3760/cma.j.issn.2095-1477.2018.07.009.
8.	杨婧, 陈松, 王昀, 等. 巩膜扣带术治疗青年人孔源性视网膜脱离的疗效分析[J]. 中国实用眼科杂志, 2016, 34(4): 318-321. DOI: 10.3760/cma.j.issn.1006-4443.2016.04.004.Yang J, Chen S, Wang Y, et al. Clinical efficacy of primary scleral buckling for rhegmatogenous retinal detachment in youths[J]. Chin J Pract Ophthalmol, 2016, 34(4): 318-321. DOI: 10.3760/cma.j.issn.1006-4443.2016.04.004.
9.	田超伟, 王雨生, 窦国睿, 等. 巩膜扣带术术中放液后视网膜下出血的临床观察[J]. 眼科, 2019, 28(5): 371-373. DOI: 10.13281/j.cnki.issn.1004-4469.2019.05.013.Tian CW, Wang YS, Dou GR, et al. Clinical observation of subretinal hemorrhage after fluid drainage during scleral buckling surgery[J]. Ophthalmol CHN, 2019, 28(5): 371-373. DOI: 10.13281/j.cnki.issn.1004-4469.2019.05.013.
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1. Nilsen BR, Alberti M, Bjerrum SS, et al. The incidence of rhegmatogenous retinal detachment in increasing[J/OL]. Acta Ophthalmol, 2020, 2020: E1-3[2020-02-21]. https://doi.org/10.1111/aos.14380. DOI: 10.1111/aos.14380. [publishedonline ahead of print].
2. Liao L, Zhu XH. Advances in the treatment of rhegmatogenous retinal detachment[J]. Int J Ophthalmol, 2019, 12(4): 660-667. DOI: 10.18240/ijo.2019.04.22.
3. Zhang Z, Peng M, Wei Y, et al. Pars plana vitrectomy with partial tamponade of filtered air in rhegmatogenous retinal detachment caused by superior retinal breaks[J]. BMC Ophthalmol, 2017, 12, 17(1): 64. DOI: 10.1186/s12886-017-0459-6.
4. Noori J, Bilonick RA, Eller AW. Scleral buckle surgery for primary retinal detachment without posterior vitreous detachment[J]. Retina, 2016, 36(11): 2066-2071. DOI: 10.1097/IAE.0000000000001075.
5. Adelman RA, Parnes AJ, Ducournau D. Strategy for the management of uncomplicated retinal detachments: the European vitreo-retinal society retinal detachment study report 1[J]. Ophthalmology, 2013, 120(9): 1804-1808. DOI: 10.1016/j.ophtha.2013.01.070.
6. Gloor BP, Marmor MF. Controversy over the etiology and therapy of retinal detachment: the struggles of jules gonin[J]. Surv Ophthalmol, 2013, 58(2): 184-195. DOI: 10.1016/j.survophthal.2012.09.002.
7. 李云鹏, 李丹丹, 曾蕊, 等. 手术显微镜下微创巩膜扣带术治疗孔源性视网膜脱离[J]. 中华眼外伤职业眼病杂志, 2018, 40(7): 512-514. DOI: 10.3760/cma.j.issn.2095-1477.2018.07.009.Li YP, Li DD, Zeng R, et al. Minimally invasive scleral buckling surgery under operating microscope for the treatment of rhegmatogenous retinal detachment[J]. Chin J Ophthalmol Vis Sci, 2018, 40(7): 512-514. DOI: 10.3760/cma.j.issn.2095-1477.2018.07.009.
8. 杨婧, 陈松, 王昀, 等. 巩膜扣带术治疗青年人孔源性视网膜脱离的疗效分析[J]. 中国实用眼科杂志, 2016, 34(4): 318-321. DOI: 10.3760/cma.j.issn.1006-4443.2016.04.004.Yang J, Chen S, Wang Y, et al. Clinical efficacy of primary scleral buckling for rhegmatogenous retinal detachment in youths[J]. Chin J Pract Ophthalmol, 2016, 34(4): 318-321. DOI: 10.3760/cma.j.issn.1006-4443.2016.04.004.
9. 田超伟, 王雨生, 窦国睿, 等. 巩膜扣带术术中放液后视网膜下出血的临床观察[J]. 眼科, 2019, 28(5): 371-373. DOI: 10.13281/j.cnki.issn.1004-4469.2019.05.013.Tian CW, Wang YS, Dou GR, et al. Clinical observation of subretinal hemorrhage after fluid drainage during scleral buckling surgery[J]. Ophthalmol CHN, 2019, 28(5): 371-373. DOI: 10.13281/j.cnki.issn.1004-4469.2019.05.013.
10. Khan B, Anand VS, Wasil A, et al. Excellent results of scleral buckling in the era of microincision vitreous surgery[J]. Egypt Retina J, 2017, 4(1): 6-8. DOI: 10.4103/erj.erj_15_16.

Chinese Journal of Ocular Fundus Diseases

The clinical analysis of scleral buckling for rhegmatogenous retinal detachment of 376 patients

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