J Korean Ophthalmol Soc.  2016 Oct;57(10):1586-1591. 10.3341/jkos.2016.57.10.1586.

Prognostic Factors of Anatomical Success in Scleral Buckling for High Myopic Rhegmatogenous Retinal Detachment

• Kwon H
• Shin MK
• Park SW
• Byon IS
• Lee JE
• Oum BS

• KMID: 2355414
• DOI: http://doi.org/10.3341/jkos.2016.57.10.1586

Abstract

PURPOSE
To assess the prognostic factors associated with anatomical success of scleral buckle (SB) for rhegmatogenous retinal detachment (RRD) in high myopia patients.
METHODS
The medical records of RRD in highly myopic eyes treated with SB from January 2009 to December 2013 were reviewed retrospectively. Cases with history of intraocular surgery including phacoemulsification and vitrectomy were excluded. Correlations between anatomical success and the parameters of age, sex, preoperative visual acuity, axial length, presence of large tear, presence of horseshoe tear, the number of tears, involved fovea, and extent of detachment were analyzed.
RESULTS
This study included 80 eyes of 80 patients. Average age and axial length were 32.3 ± 13.4 and 26.753 ± 0.961 mm, respectively. Sixty-nine eyes (86.3%) were reattached following primary surgery. Univariate analysis revealed that age (p = 0.011), presence of large tear (p = 0.002), and presence of horseshoe tear (p = 0.044) were correlated with anatomical success after SB. Based on multivariate logistic regression analysis, age was the sole independent prognostic factor (odds ratio = 1.086, 95% confidence interval = 1.022~1.154, p = 0.004).
CONCLUSIONS
A younger age is associated with a higher rate of primary anatomical success of SB for RRD in highly myopic eyes. In young, highly myopic patients with RRD, SB should be considered as the primary procedure.

Keyword

Anatomical success; High myopia; Prognostic factor; Rhegmatogenous retinal detachment; Scleral buckle

MeSH Terms

Humans
Logistic Models
Medical Records
Myopia
Phacoemulsification
Retinal Detachment*
Retinaldehyde*
Retrospective Studies
Scleral Buckling*
Tears
Visual Acuity
Vitrectomy
Retinaldehyde

Reference

References

1. Curtin BJ. The Myopias: Basic Science and Clinical Management. Philadelphia: Harper & Row;1985. p. 237–435.

2. Sperduto RD, Seigel D, Roberts J, et al. Prevalence of myopia in the United States. Arch Ophthalmol. 1983; 101:405–7.

3. Michaels DD. Visual Optics and Refraction: A Clinical Approach. 2nd ed.St Louis: Mosby;1980. p. 513.

4. Gilmartin B. Myopia: precedents for research in the twenty-first century. Clin Experiment Ophthalmol. 2004; 32:305–24.

5. Burton TC. Preoperative factors influencing anatomic success rates following retinal detachment surgery. Trans Sect Ophthalmol Am Acad Ophthalmol Otolaryngol. 1977; 83(3 Pt 1):OP499–505.

6. Schepens CL. Retinal Detachment and Allied Disease. 2. Philadelphia: WB Saunders;1983. p. 156–69.

7. Glazer LC, Mieler WF, Devenyi RG, et al. Complications of abdominal scleral buckling procedures in high myopia. Retina. 1990; 10:170–2.

8. Mansour AM, Traboulsi EI, Jalkh AE. Failure of subretinal fluid drainage during scleral buckling procedure in high myopia. Ann Ophthalmol. 1985; 17:636–7.

9. Byer NE. Clinical study of lattice degeneration of the retina. Trans Am Acad Ophthalmol Otolaryngol. 1965; 69:1065–81.

10. Haimovici R, Nicholson DH. Lattice degeneration of the retina. Albert DM, Jakobiec FA, editors. Principles and Practices of Ophthalmology: Clinical Practice. 2nd ed.Philadelphia: WB Saunders;2000. chap. 174.

11. Karlin DB, Curtin BJ. Peripheral chorioretinal lesions and axial length of the myopic eye. Am J Ophthalmol. 1976; 81:625–35.

12. Brazitikos PD, Androudi S, Christen WG, Stangos NT. Primary pars plana vitrectomy versus scleral buckle surgery for the abdominal of pseudophakic retinal detachment: a randomized clinical trial. Retina. 2005; 25:957–64.

13. Pastor JC, Fernáandez I, Rodríguez de la Rúa E, et al. Surgical abdominals for primary rhegmatogenous retinal detachments in phakic and pseudophakic patients: the Retina 1 Project-report 2. Br J Ophthalmol. 2008; 92:378–82.

14. Afrashi F, Akkin C, Egrilmez S, et al. Anatomic outcome of scleral buckling surgery in primary rhegmatogenous retinal detachment. Int Ophthalmol. 2005; 26:77–81.

15. Heimann H, Bartz-Schmidt KU, Bornfeld N, et al. Scleral buckling versus primary vitrectomy in rhegmatogenous retinal detachment: a prospective randomized multicenter clinical study. Ophthalmology. 2007; 114:2142–54.

16. Sharma YR, Karunanithi S, Azad RV, et al. Functional and anatomic outcome of scleral buckling versus primary vitrectomy in abdominal retinal detachment. Acta Ophthalmol Scand. 2005; 83:293–7.

17. Feltgen N, Heimann H, Hoerauf H, et al. Scleral buckling versus primary vitrectomy in rhegmatogenous retinal detachment study (SPR study): risk assessment of anatomical outcome. SPR study report no. 7. Acta Ophthalmol. 2013; 91:282–7.

18. Kwok AK, Cheng LL, Tse MW, et al. Outcomes of primary abdominal retinal detachment in myopes of five or more diopters. Ophthalmic Surg Lasers. 2002; 33:188–94.

19. Cheng SF, Yang CH, Lee CH, et al. Anatomical and functional abdominal of surgery of primary rhegmatogenous retinal detachment in high myopic eyes. Eye (Lond). 2008; 22:70–6.

20. Bernheim D, Rouberol F, Palombi K, et al. Comparative abdominal study of rhegmatogenous retinal detachments in phakic or pseudophakic patients with high myopia. Retina. 2013; 33:2039–48.

21. Park SW, Kwon HJ, Shin MK, et al. Impact of age on scleral abdominal surgery for rhegmatogenous retinal detachment. J Korean Ophthalmol 2017. [In press].

22. Koh TH, Choi MJ, Cho SW, et al. Scleral buckling and primary abdominal in simple rhegmatogenous retinal detachment. J Korean Ophthalmol Soc. 2010; 51:366–71.

23. Wong CW, Wong WL, Yeo IY, et al. Trends and factors related to outcomes for primary rhegmatogenous retinal detachment surgery in a large asian tertiary eye center. Retina. 2014; 34:684–92.

24. Harocopos GJ, Shui YB, McKinnon M, et al. Importance of abdominal liquefaction in age-related cataract. Invest Ophthalmol Vis Sci. 2004; 45:77–85.

25. Sharma T, Challa JK, Ravishankar KV, Murugesan R. Scleral buckling for retinal detachment. Predictors for anatomic failure. Retina. 1994; 14:338–43.

26. Oshima Y, Yamanishi S, Sawa M, et al. Two-year follow-up study comparing primary vitrectomy with scleral buckling for mac-ula-off rhegmatogenous retinal detachment. Jpn J Ophthalmol. 2000; 44:538–49.

27. Kuhn F, Aylward B. Rhegmatogenous retinal detachment: a reappraisal of its pathophysiology and treatment. Ophthalmic Res. 2014; 51:15–31.

28. Park SW, Kwon HJ, Kim HY, et al. Comparison of scleral buckling and vitrectomy using wide angle viewing system for abdominal retinal detachment in patients older than 35 years. BMC Ophthalmol. 2015; 15:121.