PRIMARY VITRECTOMY VERSUS SCLERAL BUCKLING IN PATIENTS WITH RETINAL DETACHMENT AFTER CATARACT SURGERY

The purpose of this study was to compare the anatomic and visual outcome of primary vitrectomy with scleral buckling in patients with retinal detachment following cataract surgery. Fifty-six consecutive patients with retinal detachment after cataract surgery were randomly assigned to two treatment groups: standard scleral buckling and standard three-port deep vitrectomy. Successful treatment was defined as improvement in vision (minimum of 2 lines in Snellen chart), anatomic reattachment and prevention of post-operative proliferative vitreo-retinopathy (PVR). The prognostic role of pre-operative and intra-operative conditions of the affected eye was also evaluated. Twenty-six of fifty-six eligible patients underwent scleral buckling and thirty had deep vitrectomy. Anatomic reattachment was achieved in 18 (69.2%) cases in scleral buckling group and 19 (63%) cases in vitrectomy group. Improvement in visual acuity was achieved in 76.9% and 83.3% and PVR occurred post-operatively in 23.1% and 16.7%, respectively. The differences were not statistically significant, and pre- and intra-operative ocular conditions did not prove to be prognostic factors, either. Scleral buckling and primary deep vitrectomy seem to have comparable outcomes in terms of anatomic reattachment and visual improvement in patients with pseudophakic and aphakic retinal detachment. Failure to achieve anatomic reattachment and visual improvement or PVR occurred in about one third and one fifth of the cases respectively, irrespective of the technique used. This warrants further research to improve treatment results