Anatomical and functional factors influencing the results of scleral buckling procedure for macula-off rhegmatogenous retinal detachments

Igor Kovačević; Aleksandra Radosavljević; Ivan Stefanović; Bojana Radović; Jelena Karadžić; Dragana Kovačević Pavićević; Olgica Djurković Djaković

doi:10.2298/VSP141001175K

Igor Kovačević Clinic for Eye Diseases, Clinical Centre of Serbia, Belgrade, Serbia; †Faculty of Medicine, University of Belgrade, Belgrade, Serbia
Aleksandra Radosavljević Clinic for Eye Diseases, Clinical Centre of Serbia, Belgrade, Serbia; †Faculty of Medicine, University of Belgrade, Belgrade, Serbia
Ivan Stefanović Clinic for Eye Diseases, Clinical Centre of Serbia, Belgrade, Serbia; †Faculty of Medicine, University of Belgrade, Belgrade, Serbia
Bojana Radović Clinic for Eye Diseases, Clinical Centre of Serbia, Belgrade, Serbia
Jelena Karadžić Clinic for Eye Diseases, Clinical Centre of Serbia, Belgrade, Serbia
Dragana Kovačević Pavićević Clinic for Eye Diseases, Clinical Centre of Serbia, Belgrade, Serbia; †Faculty of Medicine, University of Belgrade, Belgrade, Serbia
Olgica Djurković Djaković Institute for Medical Research, University of Belgrade, Belgrade, Serbia

DOI: https://doi.org/10.2298/VSP141001175K

Keywords: retinal diseases, retinal detachment, ophthalmologic surgical procedures, treatment outcome,

Abstract

Background/Aim. Rhegmatogenous retinal detachment is a potentially blinding condition of the posterior segment of the eye. Currently, the only treatment modality is surgery and surgical options include scleral buckling, pars plana vitrectomy and pneumoretinopexy. Many factors may influence the outcome of the surgery. Well defined indications are essential for achieving the best postoperative results. The aim of this study was to assess anatomical and functional outcome of treatment with scleral buckling for macula-off rhegmatogenous retinal detachments. Methods. This prospective, nonrandomized, interventional study included consecutive patients underwent scleral buckling for macula-off retinal detachment in the tertiary centre for vitreoretinal surgery. Results. A total of 168 consecutive patients (mean age 58.2 ± 13.9 years) were included in the study. Postoperatively, anatomical success was achieved in 152 (90.5%) of the patients. Parameters that influenced the anatomical success included the number of retinal breaks (p = 0.040), lens status (p = 0.041), preoperative proliferative vitreoretinopathy (p < 0.001), patients’ age (p = 0.049), and marginally, the presence of typical symptoms (p = 0.057). Duration of macular detachment, previous ocular trauma and refraction of the eye did not affect the anatomical result. Functional success was evaluated using the postoperative visual acuity and depended mainly on the duration of macular detachment prior the surgery. Visual acuity 0.4 or better was significantly more often achieved if duration of macular detachment was up to seven days (p < 0.001). Refraction and patients’ age did not influence the functional result. Conclusion. Scleral buckling is an efficient surgical procedure for treatment of patients with retinal detachment. Optimal results are achieved if operation is performed within the first seven days of duration of macular detachment.

Author Biographies

Igor Kovačević, Clinic for Eye Diseases, Clinical Centre of Serbia, Belgrade, Serbia; †Faculty of Medicine, University of Belgrade, Belgrade, Serbia

Vitreoretinal surgery Department, Ophthalmology specialist

Aleksandra Radosavljević, Clinic for Eye Diseases, Clinical Centre of Serbia, Belgrade, Serbia; †Faculty of Medicine, University of Belgrade, Belgrade, Serbia

Uveitis Department, ophthalmology specialist

Ivan Stefanović, Clinic for Eye Diseases, Clinical Centre of Serbia, Belgrade, Serbia; †Faculty of Medicine, University of Belgrade, Belgrade, Serbia

Vitreoretinal surgery Department, Professor, Chief of Department

Bojana Radović, Clinic for Eye Diseases, Clinical Centre of Serbia, Belgrade, Serbia

Vitreoretinal surgery Department, Ophthalmology resident

Jelena Karadžić, Clinic for Eye Diseases, Clinical Centre of Serbia, Belgrade, Serbia

Vitreoretinal surgery Department, Ophthalmology specialist

Dragana Kovačević Pavićević, Clinic for Eye Diseases, Clinical Centre of Serbia, Belgrade, Serbia; †Faculty of Medicine, University of Belgrade, Belgrade, Serbia

Uveitis Department, professor, Chief of Department

Olgica Djurković Djaković, Institute for Medical Research, University of Belgrade, Belgrade, Serbia

Chief of Department

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