Risk factors for scleral buckle removal: a matched, case-control study.
OBJECTIVE
To identify preoperative, perioperative, and postoperative risk factors for scleral buckle (SB) removal.


METHODS
Retrospective, consecutive, matched, case-control study.


METHODS
Cases included all patients undergoing SB removal between August 1988 and December 2007 at a single academic center. Cases were matched against four randomly selected control patients who underwent SB implantation during the same year as the case. Odds ratios (OR) were calculated for each factor investigated.


RESULTS
Forty cases of SB removal and 148 matched control cases were identified. Three cases of SB removal were omitted from analysis because of incomplete records. Factors associated with SB removal for any reason, using univariate analysis, included concurrent globe-penetrating injury at time of SB placement (OR, 24; 95% confidence interval [CI], 2.9 to 200), concurrent pars plana vitrectomy (PPV) (OR, 17.3; 95% CI, 4.9 to 61), diabetes mellitus (DM) (OR, 7.3; 95% CI, 1.8 to 30), prior chronic topical ocular therapy (OR, 4.3; 95% CI, 1.7 to 11), and subsequent ocular procedures (OR, 3.4; 95% CI, 1.5 to 7.5). Factors independently associated with SB removal using multivariate analysis included concurrent globe-penetrating injury (OR, 27.3; 95% CI, 1.7 to 426), concurrent PPV (OR, 11.3; 95% CI, 2.9 to 45), DM (OR, 8.9; 95% CI, 1.3 to 58), and subsequent ocular procedures (OR, 3.9; 95% CI, 1.4 to 11). Factors that did not alter SB removal risk included patient age; gender; and type, size, or location of buckling elements used.


CONCLUSIONS
Awareness of these risk factors may be valuable for the surgical planning of retinal detachment repair in patients at higher risk for subsequent SB removal and for risk stratification subsequent to SB implantation.
Covert
Douglas J
DJ
Retina Service of the Eye Institute, Medical College of Wisconsin, 925 North 87th Street, Milwaukee, WI 53226, USA.
Wirostko
William J
WJ
Han
Dennis P
DP
Lindgren
Kevin E
KE
Hammersley
Jill A
JA
Connor
Thomas B
TB
Kim
Judy E
JE
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D020878:Device Removal; D048909:Diabetes Complications; D005260:Female; D006801:Humans; D007223:Infant; D007431:Intraoperative Complications; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012163:Retinal Detachment / Q000601:surgery*; D012189:Retrospective Studies; D012216:Rheumatic Diseases / Q000150:complications; D012307:Risk Factors; D012591:Scleral Buckling / Q000295:instrumentation*