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SUPPLEMENTAL SCLERAL BUCKLE IN VITRECTOMY FOR THE REPAIR OF RHEGMATOGENOUS RETINAL DETACHMENT

2015; Lippincott Williams & Wilkins; Volume: 35; Issue: 11 Linguagem: Inglês

10.1097/iae.0000000000000797

1539-2864

K. Totsuka, Hiroko Inui, Murilo Felix Roggia, Kazunori Hirasawa, Yasuo Noda, Takashi Ueta,

Glaucoma and retinal disorders

In Brief Purpose: To evaluate the effect of supplemental scleral buckle (SB) in pars plana vitrectomy (PPV) for rhegmatogenous retinal detachment. Methods: MEDLINE, EMBASE, and CENTRAL were searched to identify studies comparing PPV with supplemental SB (PPV + SB) to PPV alone for the repair of rhegmatogenous retinal detachment. The outcome measures were primary and final reattachment rates, and postoperative complications. Odds ratio with 95% confidence interval in random effects for the comparison of outcomes between PPV + SB and PPV alone was calculated. Results: Ten studies consisting of 1,704 patients were included. Meta-analysis showed that the overall primary reattachment rate was significantly higher in PPV + SB than PPV alone (odds ratio, 1.70; 95% confidence interval, 1.21–2.39; P = 0.002). The final reattachment rate was equally high in both groups. Postoperative development of epiretinal membrane was more frequent in PPV + SB than in PPV alone (odds ratio, 1.89; 95% confidence interval, 1.30–2.76; P = 0.001), whereas no significant difference in postoperative development of macular edema, proliferative vitreoretinopathy, or elevation of intraocular pressure was found. Conclusion: Supplemental SB increases the primary reattachment rate in PPV for rhegmatogenous retinal detachment, although final reattachment rate was equally high with or without SB. Systematic review and meta-analysis of 10 studies with 1,704 patients disclosed that supplemental scleral buckle improved the primary reattachment rate in vitrectomy for rhegmatogenous retinal detachment, although final reattachment was equally high with or without scleral buckle.