Application of scleral buckling in failure cases of vitrectomy for retinal detachment

Objective To evaluate the effects of scleral buckling in failure cases of vitrectomy.Design Retrospective case series.Participants 43 eyes of 43 patients with non-reduction retina after vitrectomy.Methods Retinal cryocoagulation,scleral buckling and drainage of subretinal fluid were used via indirect ophthalmoscope in 43 failure cases(43 eyes) after vitrectomy.As for the eyes filled with silicon oil,the silicon oil was removed one to four weeks after scleral buckling.Main Outcome Measures The reattachment of the detached retina,visual acuity,intraocular pressure,and complications after scleral bucking.Results 11 eyes of 12 eyes which only received vitrectomy or combined with gas intraocular tamponade before were successfully reattached after scleral buckling in the first time,the other eye received vitrectomy combined with silicon oil tamponade after scleral buckling failed.For most cases(22 eyes of 24 eyes) filled with silicon oil,the retina reattached after buckling surgery once,and the silicon oil was removed 1～4 weeks later.The other two cases,for which the silicon oil were removed in combination of local retinotomy and intraocular tamponade with silicon oil again,and one eye was healed,the other eye became atrophic because of severe proliferative vitreous retinopathy.6 eyes of 7 eyes with redetachment retina after silicon oil removing healed after the surgery,1 eye received silicon oil tamponade again.Over all,followed up for 3～72 months,39 eyes(90.7%) were healed with scleral buckling in the first time,42 eyes(97.7%) were healed at the last follow-up.Conclusion Scleral buckling is an effective treatment for the failure cases of vitrectomy in which the retinal hole localized peripherally or the retinal detachment existed inferiorly.