NONDRAINAGE SCLERAL BUCKLING IN THE MODERN VITRECTOMY ERA.

Objective: To evaluate outcomes of rhegmatogenous retinal detachment treated with a scleral buckle (SB) without external drainage of subretinal fluid during the modern vitrectomy era.

Methods: The records of 107 eyes of 107 patients who underwent treatment with nondrainage SB surgery for primary rhegmatogenous retinal detachment with at least 3 months of follow-up were reviewed.

Results: SB surgery included segmental elements (radial, 44.9%; circumferential, 23.4%) and encircling procedures (31.8%). Most patients (68.2%) were aged younger than 60 years, and most eyes (89.7%) were phakic. Single breaks were present in 53.3% of the eyes. The macula was attached preoperatively in 66 eyes (61.7%). Myopia > 5.5 diopters (35.5%) and lattice degeneration (48.6%) were notable risk factors. Posterior vitreous detachment was present in 37.4% of the eyes. Single surgery retinal reattachment was achieved in 104 eyes; three of these eyes also received pneumatic gas injections postoperatively. Four eyes underwent anatomically successful repeat surgery, including one eye that developed a recurrent rhegmatogenous retinal detachment after release of an encircling element. One eye underwent removal of an exposed SB without sequelae, and one eye developed persistent diplopia treated with prism.

Conclusions: With proper case selection, nondrainage SB remains an excellent surgical procedure for repair of rhegmatogenous retinal detachment in the modern vitrectomy era.