Success rates of retinal buckling surgery: relationship to refractive error and lens status: results from a large German case series.

OBJECTIVE

First, to evaluate the anatomic success rates of scleral buckling surgery in the treatment of rhegmatogenous retinal detachment and possible differences in outcome depending on patients' refractive error and lens status. Second, to evaluate demographic characteristics of patients with retinal detachment to contribute to our knowledge of the epidemiology of this important and sight-threatening disease.

DESIGN

Retrospective interventional case series.

PARTICIPANTS

The Munster Study on Therapy Achievements in Retinal Detachment (MUSTARD) is one of the largest case series of patients with retinal detachment and their outcome after buckling surgery ever established, with 4325 subjects who underwent surgery between 1980 and 2001.

METHODS

All 4325 patients with retinal detachment underwent scleral buckling surgery.

MAIN OUTCOME MEASURES

Complete anatomic attachment of the retina.

RESULTS

The overall success rate in all 4325 MUSTARD cases was 83.98%. The highest success rate was achieved in patients aged 51 to 60 years, with 86.72%. With regard to refractive error, success rates were highest in moderate myopes, that is, in 707 patients with a refractive error between -2.75 and -8.0 diopters (86.70%) and in 573 patients with mild myopia between -0.5 and -2.0 diopters (86.21%). The lens status did not play a significant role in outcome. In patients with nontrauma-related retinal detachment, success rates were 84.45% for phakic patients, 82.88% for pseudophakic patients, and 81.88% for aphakic patients. An epidemiologically surprising result was the lower than expected number of myopic individuals among patients with retinal detachment: Only approximately one quarter had myopia of -2.75 diopters or more. In phakic patients aged 51 to 80 years, only 16% were myopic.

CONCLUSIONS

Scleral buckling is an established and generally successful method for the treatment of retinal detachment. As our case series has demonstrated, myopia, aphakia, and pseudophakia do not constitute factors that might diminish the chances of success.

FINANCIAL DISCLOSURE(S): Proprietary or commercial disclosure may be found after the references.