Anatomical and visual outcomes of three different scleral buckling techniques

Purpose: To compare the anatomical and visual outcomes of three different scleral buckling techniques and to explore the effect of cryotherapy and subretinal fluid drainage (SRFD) on outcomes of surgery. Methods: This retrospective study was performed on 111 eyes of 109 patients undergoing scleral buckling for rhegmatogenous retinal detachments (RRDs) by a single surgeon. Pre-, intra- and postoperative data were retrieved from hospital records. Results: Buckles were radial in 27 (24.3%), circumferential (segmental) in 16 (14.4%) and encircling in 68 (61.3%) eyes. Anatomical and visual results were comparable with all three buckling techniques. Application of cryotherapy, the spot number, and SRFD did not affect anatomical and visual results. The only preoperative factor associated with poorer anatomical results was the presence of multiple retinal breaks (P=0.006). The following preoperative factors affected visual outcomes on univariate analysis: extent of retinal detachment (r=0.417, P=0.011) and relative afferent pupillary defect (r=0.423, P=0.02). Preoperative macular status (attached vs detached) also had a significant effect on visual outcomes (P<0.001). Based on multivariate analysis however, only preoperative macular status was significantly correlated with visual results (P=0.022). Silicone sponges placed for non-encircling surgery were removed due to ocular dysmotility in 4 (3.6%) eyes, cosmetic reasons in 3 (2.7%) cases and extrusion in 2 (1.8%) eyes. One encircling tire was also removed due to extrusion. Conclusion: Surgical technique and performing cryotherapy or SRFD do not seem to influence the anatomical and visual outcomes of scleral buckling. Postoperative complications seem to be more prevalent with non-encircling techniques.