A retrospective study comparing outcomes of primary rhegmatogenous retinal detachment repair by scleral buckling and pars plana vitrectomy in Finland.
BACKGROUND
Rhegmatogenous retinal detachment (RRD) is the most common form of retinal detachment and an ophthalmic emergency. Here, we compared outcomes of primary RRD eyes operated with conventional scleral buckling (SB) with cryoretinopexy to those operated with standard pars plana vitrectomy (PPV).


METHODS
This is an institutional, retrospective, register-based, observational, comparative study. Based on the surgical procedure, 319 eyes of 319 patients were divided into two groups: SB plus cryotherapy (n=50) and PPV (n=269). Changes in intraocular pressure (IOP) and best-corrected visual acuity (BCVA) were recorded at 30 days and reoperation rates within 180 days postoperatively.


RESULTS
Eyes operated with PPV had less reoperations within the first 180 days as compared with SB eyes (P=0.001, log-rank test); however, changes in IOP were more prominent (mean ± standard deviation: +8.1±8.8 vs. +4.4±7.0 mmHg, respectively;P=0.006). Changes in BCVA did not differ between the surgical procedures.


CONCLUSIONS
PPV was associated with higher primary anatomic success rates and lower risk of reoperation but significant IOP elevation when compared to SB. These factors should be case-specifically considered when choosing treatment modality for primary RRD.
Department of Anesthesiology, Helsinki University Central Hospital, Helsinki.
Sari
S
Sahanne
Department of Ophthalmology, Kymenlaakso Central Hospital, Kotka.
Raimo
R
Tuuminen
Hjelt Institute, Faculty of Medicine, University of Helsinki.
Jari
J
Haukka
Unit of Vitreoretinal Surgery, Department of Ophthalmology, Helsinki University Central Hospital, University of Helsinki, Helsinki, Finland.
Sirpa
S
Loukovaara
rhegmatogenous retinal detachment; scleral buckling; vitrectomy