SURGICAL FAILURES AFTER PRIMARY SCLERAL BUCKLING FOR RHEGMATOGENOUS RETINAL DETACHMENT
Samir Patel, Mirataollah Salabati, Raziyeh Mahmoudzadeh, Anthony Obeid, Ajay E. Kuriyan, Yoshihiro Yonekawa, Michael A. Klufas, Sunir J. Garg, Jason Hsu, Khan Ma
Abstract
PURPOSE: To compare proliferative vitreoretinopathy (PVR)-related surgical failure and non-PVR-associated failure after scleral buckling for primary rhegmatogenous retinal detachment. METHODS: In this single-center, retrospective, consecutive case series, eyes with surgical failure after scleral buckling for primary rhegmatogenous retinal detachment were identified. Eyes with surgical failure were categorized as PVR-associated and non-PVR-associated failure, and these groups were compared. RESULTS: Of the 530 scleral buckling procedures performed, 69 were surgical failures (13%), of which 27 of the 530 (5%) were due to PVR and 42 of the 530 (8%) were from non-PVR causes. Patients with PVR-associated failure were more likely to be smokers (P < 0.001), have a delayed presentation after symptoms (P = 0.011), have preoperative vitreous hemorrhage (P = 0.004), and have preoperative PVR (P = 0.002). Multivariate logistic regression models showed that the odds of PVR-associated failure were greater in eyes with preoperative vitreous hemorrhage (odds ratio, 8.2; P = 0.048), preoperative PVR (odds ratio, 22.7; P = 0.023), and among previous smokers (odds ratio, 28.8; P < 0.001). Thirty-two of 69 patients (46%) required one additional surgical intervention, and 37 of the 69 patients (53%) required two or more additional interventions to achieve final reattachment. CONCLUSION: Proliferative vitreoretinopathy-related surgical failure after primary scleral buckling was 5%. Risk factors for PVR-associated failure parallel those commonly referenced for pars plan vitrectomy, including smoking history, preoperative vitreous hemorrhage, and preoperative PVR.