Scleral buckle removal in the vitrectomy era: a 20-year clinical experience.
OBJECTIVE
To describe the effect of scleral buckle (SB) removal on preoperative symptoms and signs prompting removal and to assess the risk of recurrent retinal detachment (RD) after SB removal.


METHODS
A retrospective study of 36 patients who underwent SB removal between August 1988 and December 2007 was performed. Indications for SB removal, presence or absence of pain or diplopia, and recurrence of RD were recorded. Composite RD rates were estimated from previously published studies and stratified into those occurring during the previtrectomy era versus later (1980 to present).


RESULTS
Mean follow-up time was 75.5 months after SB removal. Thirty-two of 33 patients (97%) who had preoperative pain had symptom relief. Twelve of 12 patients who had clinical infection had resolution. Of the four patients with diplopia, two experienced complete resolution and two reported substantial improvement but required prisms to obtain single vision. Four of 34 patients (12%) whose retinas were attached at the time of SB removal developed recurrent RD but were successfully repaired without significant visual loss from the RD.


CONCLUSIONS
Scleral buckle removal is effective in eliminating SB-related pain and infection. Symptomatic diplopia can sometimes improve after SB removal. The rates of RD after SB removal observed in this study (12%) and in others performed in the era of vitrectomy were notably lower than those of previous reports.
Froedtert and MCW Eye Institute, Department of Ophthalmology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA. dhan@mcw.edu
Dennis P
DP
Han
Douglas J
DJ
Covert
William J
WJ
Wirostko
Jill A
JA
Hammersley
Kevin E
KE
Lindgren
D020878:Device Removal; D004172:Diplopia / Q000209:etiology / Q000628:therapy*; D015817:Eye Infections / Q000209:etiology / Q000628:therapy*; D058447:Eye Pain / Q000209:etiology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012163:Retinal Detachment / Q000209:etiology / Q000601:surgery*; D012189:Retrospective Studies; D012591:Scleral Buckling / Q000009:adverse effects*; D013997:Time Factors; D014821:Vitrectomy