Outcome of scleral buckling procedures for primary rhegmatogenous retinal detachment

Objective: to study the outcome of conventional scleral buckling procedures performed for primary rhegmatogenous retinal detachment. methods: this prospective study was conducted at khyber institute of ophthalmic medical sciences, hayatabad medical complex, peshawar, pakistan from 02-08-2008 to 29-04-2009. the outcome of fifty-six consecutive cases, operated in nine months duration, for primary rhegmatogenous retinal detachment using scleral buckling procedures, were analyzed prospectively. the main outcome measure was anatomically re-attached retina at two weeks postoperative follow-up. results: overall success rate was 85.71% (48 of 56 cases) at 2-weeks post-operative follow-up. the most common intra-operative complication was sub-retinal haemorrhage (23.21% cases), and the most common complication at first post-operative day was increased intra-ocular pressure (iop), ( 21.43% cases). the raised pressure was transient in most cases, and only 2 (3.57%) had elevated iop at 2-weeks post-op follow-up. choroidal detachment was the second commonest post-operative complication (10.7%) the un-aided visual acuity was pl or hm in 32 (57.14%) cases and better than 6/60 in 3 (5.36%) cases pre-operatively. this improved to pl/hm in 12 (21.43%) and better than 6/60 in 16 (28.57%) cases post-operatively. not very significant improvement in vision despite flat retina was found to be due to late presentation of patients, high grade pvr (grade-c) in 24 (42.86%) cases and pre-operative 'off' macula in 52 (92.86%) cases, at a short-term follow up. conclusion: scleral buckling procedures are still effective in the treatment of primary rhegmatogenous retinal detachment even in high-grade pvr cases. a fairly good success rate can be achieved by adopting the appropriate procedures.