Retinal detachments secondary to inferior retinal breaks: anatomic outcomes following the use of different surgical techniques.

Abstract

Purpose: To compare the anatomical and functional outcomes of pars plana vitrectomy (PPV) alone versus PPV with the addition of a scleral buckle in treating inferior rhegmatogenous retinal detachments (RRDs).

Methods: Comparative, retrospective cohort study including patients who were diagnosed with primary inferior RRD, defined as RRD with one or more retinal tears located between 4 and 8 hours, and divided into two treatment groups. Group 1 patients were treated with PPV and gas tamponade alone, whereas group 2 patients were treated with PPV, gas tamponade and the addition of an encirclement band. Demographic and clinical features were collected, and surgical outcomes of both groups were analysed. A univariable logistic regression model evaluated the factors influencing surgical success.

Results: A total of 161 eyes were included in the study. The average age at diagnosis was 64.1 years. There was a male predominance (66.5%), and most patients had macula-off detachments (54%). Group 1 included 75 eyes (43.1%), whereas group 2 included 86 eyes (56.9%). Baseline best-corrected visual acuity was 1.00 logMAR, improving to 0.62 logMAR at the last visit (p=0.003). No significant difference in primary success rate was observed between the two groups (86.0% with encirclement band vs 80.0% without; p=0.3). The mean follow-up period was 29 weeks (SD 39).

Conclusions: PPV alone may be as effective as PPV with an encirclement band when treating inferior RRDs. The choice of tamponade does not appear to significantly influence anatomical success, and short-acting gas can be considered sufficient for favourable outcomes.