CLINICAL OUTCOMES OF SCLERAL BUCKLING IN ELDERLY PATIENTS WITH RHEGMATOGENOUS RETINAL DETACHMENT: A Retrospective Cohort Study.

Abstract

To evaluate the outcomes of scleral buckling in elderly patients with rhegmatogenous retinal detachment and identify independent predictors of postoperative visual outcomes. This retrospective study included 290 eyes from 278 patients who underwent scleral buckling between 2018 and 2024. Patients aged ≥60 years were defined as the elderly group; those ≤30 years served as controls. Clinical parameters and surgical outcomes were analyzed. Logistic regression was performed in the elderly group to identify predictors of final visual acuity. In elderly patients, scleral buckling achieved a single-surgery anatomical success (SSAS) rate of 98.23%, with 92.03% showing stable or improved vision. Compared to younger patients, the elderly group had lower rates of postoperative intraocular pressure elevation (7.08% vs. 25.99%, P < 0.001) and subretinal hemorrhage (2.65% vs. 9.60%, P = 0.023) but a higher prevalence of posterior vitreous detachment (PVD; 71.7% vs. 17.5%, P < 0.001), which was associated with break location and rhegmatogenous retinal detachment quadrant ( P < 0.001). In the elderly group, multivariate analysis identified baseline visual acuity, macula-on status, and Grade C proliferative vitreoretinopathy as independent predictors of visual outcomes ( P < 0.05). Scleral buckling remains a safe and effective option for selected elderly rhegmatogenous retinal detachment patients. Proper case selection and timely surgery are essential for achieving favorable outcomes in the vitrectomy era.