Surgical interventions for simple phakic fovea-splitting rhegmatogenous retinal detachment: a comparative study of scleral buckling and pars plana vitrectomy.

Abstract

Aims: To compare the efficiency of scleral buckling (SB) and pars plana vitrectomy (PPV) with or without SB in patients with primary simple phakic fovea-splitting rhegmatogenous retinal detachment (RRD).

Methods: A retrospective case-control study included 101 patients aged <55 years diagnosed with phakic fovea-splitting RRD. The primary outcome was functional success, defined as achieving a postoperative logarithm of the minimum angle of resolution best-corrected visual acuity of 0.3 or better at 6 months post-surgery. Secondary outcomes included primary and final anatomical success and postoperative complications.

Results: Fifty-one eyes underwent SB, and 50 eyes underwent PPV. In the SB group, 31 eyes (60.8%) achieved functional success compared with 22 eyes (44.0%) in the PPV group (p = 0.091). There was no significant difference in the primary anatomical success (SB = 94.1%, PPV = 94.0%) and final anatomical success (SB = 100%, PPV = 100%). The incidences of ocular hypertension, epiretinal proliferation, cystoid macular edema, and persistent subretinal fluid in the SB group were 37.3% (p = 0.059), 5.9% (p = 0.034), 3.9% (p = 0.051), and 74.5% (p < 0.001), respectively, whereas in the PPV group they were 56.0, 20.0, 16.0, and 22.0%, respectively. In multivariable analyses, PPV was significantly associated with epiretinal proliferation formation (OR: 4.000, 95% CI: 1.030-15.534, p = 0.045).

Conclusion: SB may offer comparable outcomes to PPV in managing phakic fovea-splitting RRD, and careful surgical technique selection is advised due to postoperative complications.