Surgical treatment of retinal detachment associated with degenerative retinoschisis.

Purpose: Although degenerative retinoschisis is almost always asymptomatic, retinal detachment occurs in some patients with outer layer breaks (OLBs). The purpose of this study is to evaluate the different surgical techniques used for the treatment of this condition.

Methods: Retrospective interventional case series. The patients underwent either a Scleral-Buckling procedure (SB) or a 3-port pars plana vitrectomy (V). Pre-, intra-, and post-operative data were analyzed for the two groups.

Results: Thirty eyes of 30 consecutive patients were included in the analysis. There was a statistically significant difference (0.5 ± 0.48 LogMAR units for the SB group, 1.37 ± 1.4 LogMAR units for the V group, p = 0.027) in final BCVA when the two groups were compared, whereas there was no statistically significant difference in the baseline BCVA between the two groups (p = 0.38). The proportion of cases that were successfully attached with one operation was slightly lower in the V group (62% versus 76%). Conversely, the proportion of cases that were successfully attached with more than one operation was similar in both groups (23% and 24%, respectively).

Conclusion: The present study highlights that retinoschisis-associated RD is a demanding situation to treat and remains a challenge for vitreoretinal surgeons. Scleral buckle procedure was found to be successful in eyes that have peripheral OLBs and not extensive RDs, and PPV should be considered for treating symptomatic, rather extensive schisis-RDs, especially in cases with large or posterior outer layer breaks.