Scleral buckle removal associated with pars plana vitrectomy for recurrent retinal detachment.
OBJECTIVE
Scleral buckle (SB) removal is rarely performed due to extrusion, infection, or diplopia. We report a series of patients with recurrent retinal detachment (RRD) after primary SB due to new breaks occurring at sites where the presence of a pre-existing SB was judged counterproductive. All patients were treated by means of pars plana vitrectomy (PPV) and SB removal with the sole purpose of achieving a more favorable retinal profile.


METHODS
We retrospectively reviewed all patients undergoing PPV and SB removal for RRD due to new breaks occurring at sites hidden by pre-existing exoplants.


RESULTS
Mean age was 52 years and VA on presentation was 20/620 and 20/216 at latest visit (p<0.01), 23 months of follow-up. On presentation, 3/11 (27%) had a VA better than 20/400 and 1/11 (9%) better than 20/40. At the end of follow-up, 9/11 (81%) and 3/11 (27%) saw better than 20/400 and 20/40 (p<0.05). At the end of follow-up, 8/11 (72%) had an attached retina, 2/11 (18%) had a partially attached retina, and 1/11 (9%) had a total RD. Explanted buckles included 5 silicone sponges and 6 solid silicone rubber elements.


CONCLUSIONS
Although occasionally cumbersome and time-consuming, SB removal may provide a more favorable retinal profile and improve retina-tamponade contact. Larger series are needed to assess if this translates into a significant benefit in the treatment of selected RRD.
Rossi
Tommaso
T
Ospedale Oftalmico di Roma-Unità Operativa di Chirurgia Vitreoretinica, Roma - Italy. tommaso.rossi@usa.net
Boccassini
Barbara
B
Iossa
Mario
M
Lesnoni
Guido
G
Mutolo
P Alessandro
PA
D000328:Adult; D000368:Aged; D020878:Device Removal; D005260:Female; D005466:Fluorocarbons / Q000008:administration & dosage; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012163:Retinal Detachment / Q000601:surgery*; D012189:Retrospective Studies; D012591:Scleral Buckling; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy / Q000379:methods*
D005466:Fluorocarbons