Surgical techniques in retinal detachment: scleral buckling vs circumferential + buckling

Abstract

The goal of surgery for retinal detachment is to repair the detachment obtaining the best results and the minor complications. In
cases where retinal rupture has caused excessive subcutaneous fluid accumulation, scleral buckling / circumferential techniques or
vitrectomy are adopted. In most cases, scleral buckling resolves retinal detachment anatomically and functionally within one month
The aim of the study is the evaluation of efficacy and postoperative complications in a group of patients with non complicated
rhegmatogenous retinal detachment treated with circumferential and buckling techniques, compared to the control group, treated
with buckling alone.
Fifty-three patients aged between 37 and 82 (mean age: 58.9 years) with rhegmatogenous retinal detachment were recruited from
January 2005 to March 2010. Group A patients undergone radial buckling. Patients in group B were subjected to circling with
silicone band (circumferential + buckling) application. The safety of the two surgical techniques was evaluated in terms of intra
and postoperative complications.
The results showed that both techniques are effective in treating rhegmatogenous retinal detachment. The surgery “ab externo” was
successful for the treatment of retinal detachment after first intervention in 96% of cases in Group A and 75% of patients in Group
B. The best manageability of the circumferential and buckling technique has avoided the development of intraoperative
complications. However, the number and type of postoperative complications would indicate that the circumferential + buckling
technique should not be adopted unless it is strictly necessary.
In light of the data obtained, we can state that both surgical techniques are effective in determining retinal adhesion to the retinal
pigment epithelium following rhegmatogenous retinal detachment. However, the use of buckling (minimal episcleral surgery) is safer
and guarantees a better outcome on the patient visual acuity, and is therefore preferable to the circumferential + buckling.