RETINAL DISPLACEMENT AFTER RHEGMATOGENOUS RETINAL DETACHMENT REPAIR: Scleral Buckling versus Pars Plana Vitrectomy (The BEVERLEY Study).

Abstract

To investigate the retinal displacement and metamorphopsia in patients with primary rhegmatogenous retinal detachment treated with pars plana vitrectomy or scleral buckling. This is a prospective nonrandomized interventional study. A total of 107 patients were studied over a period of 6 months postoperatively. The vessel printing on the fundus autofluorescence photos and the M-CHART were used to evaluate the retinal displacement and the metamorphopsia, respectively. We also assessed the vision-related quality of life, the postoperative visual acuity, and the optical coherence tomographic findings. Sixty-five male and 42 female patients were recruited in the study. The mean age was 54.8 years (SD 14.7, range 18-82). The proportion of eyes detected with retinal displacement at 6 months postoperatively was significantly lower in the scleral buckling group (4.3%) than in the pars plana vitrectomy group (30.9%) (26.6% difference, 95% CI 13.1%-40.1%, P < 0.001). The scleral buckling group had significantly lower postoperative vertical and horizontal metamorphopsia (45.5% difference, 95% CI 28.3%-62.7% P < 0.001 and 38.2% difference 95% CI 20.7%-55.7%, P < 0.001, respectively). There was no significant difference between the two study groups regarding the vision-related quality of life (1.19 difference, 95% CI -5.76 to 7.70, P = 0.783) and visual acuity (0.08 difference, 95% CI 0.00-0.17, P = 0.051). Although scleral buckling is not superior in visual acuity improvement and quality of life, it improves anatomical outcomes with less retinal displacement and functional outcomes with less metamorphopsia.