The clinical observation of segmental scleral bulking in treatment of rhegmatogenous retinal detachment with multiple retinal breaks

Objective To observe the effect of segmental scleral buckling on the treatment of rhegmatogenous retinal detachment (RRD) with multiple retinal breaks.Methods This is a retrospective study.Seventeen patients (17 eyes) suffering from RRD with multiple retinal breaks were enrolled in this study.There were 8 eyes with the retinal breaks located in different quadrants and 9 eyes located in different latitudes within the same quadrant.Three were 3 eyes with 2 retinal breaks,5 eyes with 3 retinal breaks,9 eyes with more than 3 retinal breaks.The forms of retinal breaks included U-shaped break (4 eyes),tear break (1 eye),degenerative break (3 eyes) or U-shaped breaks combined with degenerative breaks (7 eyes),U-shaped break.s combined with tear breaks (1 eye),tear breaks combined with degenerative breaks (1 eye).The best corrected vision acuity (BCVA) was count finger to 0.8.The segmental scleral buckling was performed in all patients with the reasonable combination of silicon sponges and tires.The mean followup was 9.3 months (from 6 to 12 months).The BCVA,retinal attachment and complications were observed in the follow-up.Results Fifteen eyes were reattached without recurrent of retinal detachment (88.2％).One eye with recurrent retinal detachment after 3 months due to proliferative vitreoretinopathy,and was partly reattached after vitrectomy combined with silicon oil tamponade.Retina remained detached in 2 eyes (11.8％),including 1 eye reattached after combined with gas tamponade,and 1 eye with vitrectomy.Sixteen eyes were completely reattached (94.1％),including 14 eyes were underwent only 1 operation (82.4％).The BCVA were improved more than 2lines in 9 eyes (52.9％),1 to2linesin5 eyes (29.4％),and only 3 eyes (17.7％) without improvement.All patients have no serious complications during the operations.Conclusion For certain patients suffering from RRD with multiple retinal breaks,a reasonable design of segmental scleral buckling can effectively increase the success rate of retinal reattachment (82.4％). Key words: Retinal detachment/surgery;  Scleral buckling