INFERIOR RETINAL DETACHMENT REPAIR USING VITRECTOMY WITH OR WITHOUT SCLERAL BUCKLING.

Abstract

To compare outcomes in inferior rhegmatogenous retinal detachment (RRD) repair using pars plana vitrectomy (PPV) or PPV with scleral buckle (PPV-SB). Patients who underwent surgery for inferior RRD at a tertiary care center between 2014 and 2018 were included. Inferior RRD was defined as RD with tears between 4:00 and 8:00 clock hours in a detached retina. Non-RRD etiologies (e.g., traumatic, tractional), proliferative vitreoretinopathy grade ≥C2, and silicone oil use were excluded. Single-surgery anatomic success was defined as the absence of reoperation for recurrent RRD during follow-up. There were 366 patients included of which 260 (71%) were operated using PPV-SB. Single-surgery anatomic success was achieved in 96 (91%) of patients with pars plana vitrectomy and 227 (87%) of patients with PPV-SB ( P = 0.38) over a median follow-up of 15 months. At the final follow-up, pinhole visual acuity was 0.18 (0.10-0.30) among patients with pars plana vitrectomy and 0.18 (0.10-0.40) among patients with PPV-SB (Snellen equivalent: 20/30; P = 0.03). After adjusting for demographic (i.e., age and sex) and preoperative characteristics (i.e., macula on status, baseline pinhole visual acuity, and grade C1 proliferative vitreoretinopathy), PPV-SB did not alter single-surgery anatomic success ( P = 0.210). Following inferior RRD repair, there were no significant differences in single-surgery anatomic success between patients undergoing pars plana vitrectomy and PPV-SB in this large, retrospective cohort.