Purpose: Rhegmatogenous retinal detachment (RRD) may be caused by a flap tear or by an atrophic hole along the lattice degeneration. The aim of this study was to see whether different types of scleral buckling could achieve comparable reattachment rates in eyes with specific types of RRD. Patients and Methods: 128 eyes with RRD were assigned to receive 1 of 3 buckling procedures according to the following guidelines: retinal detachments caused by flap tears were treated with radial segmental buckling; retinal detachments caused by atrophic holes with limited lattice degeneration were treated with circumferential segmental buckling, and retinal detachments caused by multiple breaks with extensive lattice degeneration were treated with encircling buckling. Results: 56 eyes received radial segmental buckling, 36 eyes received circumferential segmental buckling, and 36 eyes received encircling buckling. The reattachment rates in these three groups were 83.9, 86.1, and 88.9%, respectively (no statistically significant difference). The visual outcomes were comparable in all groups. Younger age, an increased requirement for subretinal fluid drainage, longer operation time, and myopic shift were noted in the encircling group. Conclusions: Comparable reattachment rates could be achieved in all three groups according to our guidelines. Segmental buckling is appropriate for two thirds of RRD in this study and has fewer complications than encircling buckling. Every retinal detachment behaves differently and should be subjected to its optimal buckling procedure to achieve the best results and to avoid unnecessary operative complications.

Keywords:
Radial segmental buckling, Circumferential segmental buckling, Encircling buckling, Primary retinal detachment
1.
Wild MR, Ruby AJ, Rosenshein J: Pneumatic retinopexy: A survey of current practice patterns among the Vitreous Society members. Ophthalmic Surg Lasers 2000;31:76–81.
2.
Williams GA, Aaberg TM: Techniques of scleral buckling; in Ryan SJ, Glaser BM (eds): Retina. St. Louis, Mosby, 1994, vol 3, pp 1979–2017.
3.
Morse PH: Selection of type of operation for rhegmatogenous retinal detachment. Trans Ophthalmol Soc UK 1978;98:147–152.
4.
Lincoff H, Kreissig I: Management of rhegmatogenous retinal detachment; in Freeman WR (ed): Practical Atlas of Retinal Disease and Therapy. New York, Raven Press, 1993, pp 221–235.
5.
Lincoff H, Kreissig I: Advantages of radial buckling. Am J Ophthalmol 1975;79:955–957.
6.
Goldbaum MH, Smithline M, Poole TA, Lincoff H: Geometric analysis of radial buckling. Am J Ophthalmol 1975;79:958–965.
7.
Kreissig I, Rose D, Jost B: Minimized surgery for retinal detachments with segmental buckling and nondrainage: An 11-year follow-up. Retina 1992;12:224–231.
8.
Sharma T, Challa JK, Ravishankar KV, Murugesan R: Scleral buckling for retinal detachment: Predictors for anatomic failure. Retina 1994;14:338–343.
9.
Sasoh M: The frequency of subretinal fluid drainage and the reattachment rate in retinal detachment surgery. Retina 1992;12:113–117.
10.
Michels RG: Scleral buckling methods for rhegmatogenous retinal detachment. Retina 1986;6:1–49.
11.
Robertson DM: Scleral buckling choices for primary retinal detachment: Vitreoretinal update. American Academy of Ophthalmology, subspecialty day 1997, pp 147–150.
12.
Hartnett ME: Primary rhegmatogenous retinal detachment; in Schepens CL, Hartnett ME, Hirose T (eds): Schepens’ Retinal Detachment and Allied Diseases, ed 2. Woburn, Butterworth-Heinemann, 2000, pp 303–305.
13.
Committee on Ophthalmic Procedure Assessment of the American Academy of Ophthalmology: The repair of rhegmatogenous retinal detachments. Ophthalmology 1996;103:1313–1324.
14.
Nagahara M, Tamaki Y, Araie M, Ehuchi S: Effects of scleral buckling and encircling procedures on human optic nerve head and retinochoroidal circulation. Br J Ophthalmol 2000;84:31–36.
15.
Takahashi K, Kishi S: Remodeling of choroidal venous drainage after vortex vein occlusion following scleral buckling for retinal detachment. Am J Ophthalmol 2000;129:191–198.
16.
Balogh T, Heinrich T, Kalman A, Messmer EP: Results of conventional retinal detachment surgery. II. Changes in refraction. Klin Monatsbl Augenheilkd 1992;200:456–458.
17.
Tanihara H, Negi A, Kawano S, Ishigouoka H, Ueda Y, Yoshida-Suzuki S, Amano H, Satou E, Honda Y: Axial length of eyes with rhegmatogenous retinal detachment. Ophthalmologica 1993;206:76–82.
18.
Okada Y, Nakamura S, Kubo E, Oishi N, Takahashi Y, Akagi Y: Analysis of changes in corneal shape and refraction following scleral buckling surgery. Jpn J Ophthalmol 2000;44:132–138.
19.
Kinoshita M, Tanihara H, Negi A, Kawano SI, Ishigouoka H, Ueda Y, Yoshida-Suzuki S, Honda Y: Vector analysis of corneal astigmatism after scleral buckling surgery. Ophthalmologica 1994;208:250–253.
20.
Hayashi H, Hayashi K, Nakao F, Hayashi F: Corneal shape changes after scleral buckling surgery. Ophthalmology 1997;104:831–837.
21.
Weinberger D, Lichter H, Loya N, Axer-Siegel R, Muzmacher L, Gabbay U, Yassur Y: Corneal topographic changes after retinal and vitreous surgery. Ophthalmology 1999;106:1521–1524.
22.
Hilton GF, Grizzard WS, Avins LR, Heilbron DC: The drainage of subretinal fluid: A randomized controlled clinical trial. Retina 1981;1:271–280.
23.
Wilkinson CP, Bradford RH Jr: Complications of draining subretinal fluid. Retina 1984;4:1–4.
24.
Aylward GW, Orr G, Schwartz SD, Leaver PK: Prospective, randomized, controlled trial comparing suture needle drainage and argon laser drainage of subretinal fluid. Br J Ophthalmol 1995;79:724–727.
25.
Pearce IA, Wong D, McGalliard J, Groenewald C: Does cryotherapy before drainage increase the risk of intraocular hemorrhage and affect outcome? Br J Ophthalmol 1997;81:563–567.
26.
Schepens CL, Marden D: Data on the natural history of retinal detachment. I. Age and sex relationship. Arch Ophthalmol 1961;66:631–642.
27.
Burton TC, Brown CK, Haimann MH: Predicting age of onset for individuals at risk of phakic retinal detachment. Trans Am Ophthalmol Soc 1983;81:149–161.
28.
Murakami-Nagasako F, Ohba N: Phakic retinal detachment associated with atrophic hole of lattice degeneration of retina. Graefes Arch Clin Exp Ophthalmol 1983;220:175–178.
© 2002 S. Karger AG, Basel
2002
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.