Scleral Buckle Surgery for Primary Retinal Detachment Without Posterior Vitreous Detachment

In Brief Purpose: To present and analyze the anatomical and functional outcomes for scleral buckling (SB) in a group of patients with rhegmatogenous retinal detachment without posterior vitreous detachment. Methods: A total of 244 patients underwent SB from 2005 through 2014 by a single surgeon (A.W.E.). Forty patients (45 eyes) were identified as fulfilling the criteria of presenting with a rhegmatogenous retinal detachment without posterior vitreous detachment. Visual outcomes, preoperative retinal findings, and the SB technique were analyzed. The main outcome measure was the primary reattachment rate at 6 months after single surgery. Results: The mean age was 29 years (range 11–51 years). The mean follow-up period was 20 months. The mean refractive error was −5.16 diopters. Subretinal fluid drainage was performed in 17 eyes (37.8%). The anatomical success rate after single SB surgery at 6 months was 91.1%. The only factor that had statistically significant correlation with primary anatomical failure was development of subretinal hemorrhage during the drainage procedure (P = 0.03). Conclusion: Despite an increasing trend toward primary vitrectomy for rhegmatogenous retinal detachment, an indication for SB is in younger patients without a preexisting posterior vitreous detachment. We showed a 91.1% success rate with a primary SB and 100% with a second surgery. Despite an increasing trend toward vitrectomy as the primary procedure for rhegmatogenous retinal detachment, scleral buckling is still a highly effective surgical technique. This is particularly the case in younger phakic patients without a preexisting posterior vitreous detachment in which vitrectomy may present a much greater challenge.