title: Scleral Buckling versus Vitrectomy for Retinal Detachment Repair: Comparison of Visual Fields and Nerve Fiber Layer Thickness.
abstract: OBJECTIVE
  To compare visual field loss and retinal nerve fiber layer (RNFL) defects in cases of rhegmatogenous retinal detachment (RRD) treated with scleral buckle (SB) versus pars plana vitrectomy (PPV) and C3F8 injection.
  
  
  METHODS
  This was a prospective, comparative interventional study of 50 eyes with primary RRD, treated with PPV (25 eyes) or SB (25 eyes). All measurements took place at least 9 months following successful and uncomplicated surgical treatment. The visual field total deviation (TD) values for preoperative attached and detached areas were calculated and compared separately. The optic nerve head morphology was studied with Heidelberg retinal tomography (HRT), and the RNFL using spectral-domain optical coherence tomography.
  
  
  RESULTS
  The preoperative detached areas demonstrated more affected TD values (in dB) compared to the preoperative attached areas (-6.9 ± 5.2 vs. -4.3 ± 3.3 for the SB group and -9.6 ± 5.2 vs. -7.8 ± 5.1 for the PPV group; p = 0.001) in both groups. The preoperative attached areas of the SB group showed better TD values (calculated mean values) compared to the preoperative attached areas of the PPV group (-4.3 ± 3.3 vs. -7.8 ± 5.1, p = 0.007). The RNFL and HRT values showed no statistically significant difference between the two groups.
  
  
  CONCLUSIONS
  It seems that the preoperative detached retina, despite successful reattachment, suffers permanent damage as a result of the detachment, irrespective of the method of treatment. In the PPV group, the postoperative functionality of the preoperative attached areas was detected to be worse compared to the postoperative functionality of the preoperative attached areas of the SB group. We postulate that this fact could be attributed to an additional traumatizing factor (possibly fluid-air exchange or gas injection) in patients with RRD treated with PPV.
authors.affiliation: Department of Ophthalmology, Vitreoretinal Division, University of Athens, Athens, Greece.
authors.forename: Chryssanthi
authors.initials: C
authors.lastname: Koutsandrea
authors.forename: Menelaos
authors.initials: M
authors.lastname: Kanakis
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Papaconstantinou
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Brouzas
authors.forename: Ioannis
authors.initials: I
authors.lastname: Ladas
authors.forename: Petros
authors.initials: P
authors.lastname: Petrou
authors.forename: Ilias
authors.initials: I
authors.lastname: Georgalas
mesh_terms: D000368:Aged; D058450:Endotamponade; D005260:Female; D005466:Fluorocarbons; D006801:Humans; D008297:Male; D008875:Middle Aged; D009412:Nerve Fibers / Q000473:pathology*; D012163:Retinal Detachment / Q000503:physiopathology / Q000601:surgery*; D012165:Retinal Ganglion Cells / Q000473:pathology*; D012591:Scleral Buckling / Q000379:methods*; D041623:Tomography, Optical Coherence; D014786:Vision Disorders / Q000503:physiopathology*; D014792:Visual Acuity / Q000502:physiology; D058609:Visual Field Tests; D014794:Visual Fields / Q000502:physiology*; D014821:Vitrectomy / Q000379:methods*
chemical_list: D005466:Fluorocarbons; C042852:perflutren