Zhu Xinlei, Xu Mengying, Chen Nan, Lun Lingxiao, Wan Lei
Eye Institute of Shandong First Medical University, Qingdao Eye Hospital of Shandong First Medical University, Qingdao, China.
State Key Laboratory Cultivation Base, Shandong Key Laboratory of Eye Diseases, Qingdao, China.
Retina. 2025 Nov 1;45(11):2057-2065. doi: 10.1097/IAE.0000000000004594.
To evaluate the outcomes of scleral buckling in elderly patients with rhegmatogenous retinal detachment and identify independent predictors of postoperative visual outcomes.
This retrospective study included 290 eyes from 278 patients who underwent scleral buckling between 2018 and 2024. Patients aged ≥60 years were defined as the elderly group; those ≤30 years served as controls. Clinical parameters and surgical outcomes were analyzed. Logistic regression was performed in the elderly group to identify predictors of final visual acuity.
In elderly patients, scleral buckling achieved a single-surgery anatomical success (SSAS) rate of 98.23%, with 92.03% showing stable or improved vision. Compared to younger patients, the elderly group had lower rates of postoperative intraocular pressure elevation (7.08% vs. 25.99%, P < 0.001) and subretinal hemorrhage (2.65% vs. 9.60%, P = 0.023) but a higher prevalence of posterior vitreous detachment (PVD; 71.7% vs. 17.5%, P < 0.001), which was associated with break location and rhegmatogenous retinal detachment quadrant ( P < 0.001). In the elderly group, multivariate analysis identified baseline visual acuity, macula-on status, and Grade C proliferative vitreoretinopathy as independent predictors of visual outcomes ( P < 0.05).
Scleral buckling remains a safe and effective option for selected elderly rhegmatogenous retinal detachment patients. Proper case selection and timely surgery are essential for achieving favorable outcomes in the vitrectomy era.
评估老年孔源性视网膜脱离患者巩膜扣带术的疗效，并确定术后视力结果的独立预测因素。
这项回顾性研究纳入了2018年至2024年间接受巩膜扣带术的278例患者的290只眼。年龄≥60岁的患者被定义为老年组；年龄≤30岁的患者作为对照组。分析临床参数和手术结果。在老年组中进行逻辑回归分析以确定最终视力的预测因素。
在老年患者中，巩膜扣带术的单次手术解剖成功率（SSAS）为98.23%，92.03%的患者视力稳定或改善。与年轻患者相比，老年组术后眼压升高（7.08%对25.99%，P<0.001）和视网膜下出血（2.65%对9.60%，P=0.023）的发生率较低，但玻璃体后脱离（PVD）的患病率较高（71.7%对17.5%，P<0.001），这与裂孔位置和孔源性视网膜脱离象限有关（P<0.001）。在老年组中，多因素分析确定基线视力、黄斑在位状态和C级增殖性玻璃体视网膜病变是视力结果的独立预测因素（P<0.05）。
对于选定的老年孔源性视网膜脱离患者，巩膜扣带术仍然是一种安全有效的选择。在玻璃体切除术时代，正确的病例选择和及时手术对于取得良好疗效至关重要。
