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Scleral or vitreous surgery in retinal detachment of recent onset

Session Details

Session Title: Vitreoretinal Surgery I

Session Date/Time: Thursday 17/09/2015 | 08:30-10:30

Paper Time: 09:58

Venue: Apollon.

First Author: : R.Malagola ITALY

Co Author(s): :    E. D'ambrosio   R. Giannotti   L. Pattavina   L. Arrico     

Abstract Details

PURPOSE:The purpose of this study is to evaluate, in patients affected by retinal detachment (RD) of recent onset, in which percentage scleral buckling (SB) technique vs pars plana vitrectomy (PPV) is choosen and performed. We assess the overall single shot success rate, and the success in the two groups of scleral buckling and pars plana vitrectomy. We also consider some features of retinal detachment associated or not, in the choice of the type of surgery ( scleral buckling vs pars plana vitrectomy).

Setting:

In patients undergoing surgery for retinal detachment (RD ) of recent onset, between 2008 and 2013 in Department of Sense Organs Sapienza University - Umberto I Hospital of Rome

Methods:

In patients undergoing surgery for retinal detachment (RD ) of recent onset, between 2008 and 2013, sex, age, involved eye, technique, duration of surgery, preoperative and postoperative and at sixt month visual acuity, retinal detachment location, possible macular involvement were analysed. We also evaluated the scleral surgery vs vitrectomy overall percentage, the scleral operation rate (SOR), the single operation success rate (SOSR).

Results:

161 eyes operated for RD, 133 ab external with 88.7% SOSR, 28 PPV with 89,3% SOSR, with no significant difference. Visual acuity improved in all groups. PPV cases started from an inferior visual acuity as compared with the ones who had scleral surgery. Pseudophakia does not affect the choice and the success rate of scleral surgery. The extension of detachment with macular involvement and with decreased visual acuity, increased the use of vitrectomy.

Conclusions:

The ab external scleral surgery, less expensive and invasive, successfully solves the vast majority of recent onset retinal detachment cases and should be the first choice in most cases, reserving vitrectomy only to more complex, less frequent cases (giant and or posterior break). No one of the two techniques is absolutely better than the other, but is better in the specific case. Scleral buckling and PPV are therefore complementary techniques. Scleral surgery, however, requires a longer and more difficult learning curve to get good anatomical and functional results.

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