[Conventional methods in retinal detachment surgery]

Abstract

Purpose: To evaluate the usefulness of conventional methods in retinal detachment (RD) surgery basing on the relationship between factors characterizing clinical picture of the RD, the type and course of surgical procedures and the retinal reattachment.

Materials and methods: 252 patients (252 eyes), operated on in the last 5 years in our clinic were enrolled in the studies. There were 120 men and 132 women, aged 9 to 83, mean 53. In all cases scleral buckling procedures with silicone band or sponge and cryocoagulation of the breaks were used. The relationship between retinal reattachment and the following parameters were examined: visual acuity, retinal degenerations, myopia, extent of the detachment, number and kinds of breaks, macular involvement, state of vitreous, PVR, intraocular pressure, extent of scleral buckling, subretinal fluid drainage and intra- or post-operative complications.

Results: Retinal reattachment was achieved in 82% of the eyes with one operation and additionally in 7% after reoperation. The significant relationship was found between: visual acuity, intraocular pressure, extent of the detachment, number of breaks, PVR, extent of scleral buckling and retinal reattachment.

Conclusion: PVR is a significant cause of failure in RD surgery with conventional methods and PVR grade C is the threshold beyond which the percentage of reattachments decreases to about 50%. Value of other risk factors, determining severity of RD is not certain for prognosis. Cerclage with silicone band is a method of choice in the majority of RD with PVR grade B and C. Our observations do not confirm the reports of severe complications caused by cerclage, which might be connected with excessive tightening of the band.