Objective: To evaluate the effects of scleral buckling combined with intravitreal gas injection for the treatment of retinal detachment in selected eyes which had undergone vitrectomy but without silicon oil tamponade.
Methods: This was a retrospective observational case series. Including 52 eyes of 52 selected patients. All patients had undergone vitrectomy without silicon oil tamponade as the first surgery for the treatment of various vitreoretinal diseases. After the failure of the first surgery, scleral buckling combined with intravitreal gas injection were performed for the treatment of retinal detachment in Xijing Hospital between January 2001 and May 2004. The scleral buckling was used in all surgeries and using radial placement of a silicon sponge or circumferential placement of solid silicon combined with an encircling band. During the surgery, all breaks were carefully marked to ensure they were on the crest or anterior slope of the buckle. Air or C(3)F(8) gas was injected intravitreously. The reattachment rate, visual outcome, and postoperative complications were investigated.
Result: After a six-month to three-year follow-up period, the reattachment rate was 69.2% (36/52 cases). Further vitrectomy surgeries were needed for other 16 eyes. The visual acuity was improved in 32 eyes (61.5%), three eyes (23.1%) with no change, and 8 eyes (15.4%) decreased. Macular epiretinal membrane happened postoperatively in one eye, and cataract was found in another case. There is no serious complications.
Conclusions: Scleral buckling combined with intravitreal gas injection is an effective procedure for the treatment of retinal detachment in vitrectomized eyes without silicon oil tamponade. The rate of secondary vitrectomy also can be reduced.
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