Surgical interventions for simple phakic fovea-splitting rhegmatogenous retinal detachment: a comparative study of scleral buckling and pars plana vitrectomy.

AIMS

To compare the efficiency of scleral buckling (SB) and pars plana vitrectomy (PPV) with or without SB in patients with primary simple phakic fovea-splitting rhegmatogenous retinal detachment (RRD).

METHODS

A retrospective case-control study included 101 patients aged <55 years diagnosed with phakic fovea-splitting RRD. The primary outcome was functional success, defined as achieving a postoperative logarithm of the minimum angle of resolution best-corrected visual acuity of 0.3 or better at 6 months post-surgery. Secondary outcomes included primary and final anatomical success and postoperative complications.

RESULTS

Fifty-one eyes underwent SB, and 50 eyes underwent PPV. In the SB group, 31 eyes (60.8%) achieved functional success compared with 22 eyes (44.0%) in the PPV group ( = 0.091). There was no significant difference in the primary anatomical success (SB = 94.1%, PPV = 94.0%) and final anatomical success (SB = 100%, PPV = 100%). The incidences of ocular hypertension, epiretinal proliferation, cystoid macular edema, and persistent subretinal fluid in the SB group were 37.3% ( = 0.059), 5.9% ( = 0.034), 3.9% ( = 0.051), and 74.5% ( < 0.001), respectively, whereas in the PPV group they were 56.0, 20.0, 16.0, and 22.0%, respectively. In multivariable analyses, PPV was significantly associated with epiretinal proliferation formation (OR: 4.000, 95% CI: 1.030-15.534,  = 0.045).

CONCLUSION

SB may offer comparable outcomes to PPV in managing phakic fovea-splitting RRD, and careful surgical technique selection is advised due to postoperative complications.