Objective To retrospectively analyze 11 patients with recurrent retinal detachment after scleral buckling, investigate the causes and treatment of recurrent retinal detachment, and provide clinical basis for the treatment.
Methods Total 11 patients(11 eyes) with recurrent retinal detachment after scleral buckling surgery in our hospital from January 2016 to December 2017 were collected. The causes of recurrence, the choice of surgical methods and the recovery of visual function were analyzed by fundus examination, reoperation and visual acuity.
Results Fundus examination showed that in patients with recurrent retinal detachment, there were 3 eyes with primary tears, 8 eyes with new tears, 2 eyes with intraocular lens and 3 eyes with high myopia. PVR analysis showed that 1 eye was grade B, 8 eyes were grade C1, 2 eyes were grade C2. There were 5 cases(5 eyes) with old retinal detachment signs. Re-operation:scleral buckling was performed again in 1 eye, vitrectomy + C3 F8 filling in 1 eye, and vitrectomy + silicone oil filling in 9 eyes. The retina had been restored after operation in all patients. The average best corrected visual acuity of postoperative patients was 3.61±1.20, significantly higher than that of preoperative patients(3.26±1.14), with statistical significance(
t=-3.121,
P<0.05, 95%
CI:-0.592 to-0.098).
Conclusion The main causes of retinal detachment after scleral buckling surgery are the opening of the primary hole, retinal hole re-opening the new hole by the proliferation of the retina, and strong freezing during operation. High myopia and intraocular lens may be the risk factors. For young people without PVR, the scleral buckling surgery should be first choice to treat rhegmatogenous retinal detachment. In vitrectomy, the membrane should be stripped as clean as possible, and the laser should be used as the main method, and 360 degrees of laser therapy should consider. For patients with PVR grade C2 or above, silicone oil should be used firstly.
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