Scleral Buckling for Retinal Detachment Recurrence after Previously Performed Vitreoretinal Surgery in Patients with Advanced Stage of Proliferative Diabetic Retinopathy

Purpose: to study the effectiveness of scleral buckling in recurrent retinal detachment after previously performed vitreoretinal surgery in patients with advanced stage PDR.
Patients and methods. The results of treatment of 30 patients with recurrent retinal detachment after previously performed vitreoretinal surgery were analyzed. Depending on the initial localization of fibrovascular tissue and tractional retinal detachment, patients were divided into 2 groups of 15 cases each: group 1 — localization in the lower quadrants, group 2 — localization in the upper quadrants. In group 1, the average age was 44.2 ± 1.8 years, the gender distribution was as follows: 10 women and 5 men, according to the type of diabetes mellitus: type 1 diabetes — 86.6 %, type 2 diabetes — 13,3 %. In group 2, the average age was 65.8 ± 1.2 years, there were 6 men, 9 women, type 1 diabetes — 20 % of cases, type 2 diabetes — 80 % of cases. The observation period ranged from 14 months to 18 months. After detection of recurrent retinal detachment, all patients were treated with buckling within 3 weeks from the moment of relapse using local anesthesia and intravenous sedation. In all cases, a buckle made of fine-pored silicone with a diameter of 5 mm of the required length was used. Normalization of intraocular pressure was performed by dosed drainage of silicone oil into the vitreal chamber.
Results. In all cases after scleral buckling retina is attach. 6 months after the buckling, silicone oil was removed from the vitreous cavity. With a follow-up period of 3 months after removal of silicone oil, a recurrence of retinal detachment was detected in 2 cases in group 1. Long-term functional results in both groups from 14 to 18 months after completion of treatment demonstrated a significant increase in BCVA.
Conclusion. The results obtained indicate that proposed method of surgical treatment for recurrent retinal detachment after previously performed vitreoretinal surgery in patients with advanced stage PDR, provides a high level of safety and clinical effectiveness, which is confirmed by the high probability of retinal reattachment (above 93 %), low recurrence rate of retinal detachment, as well as positive dynamics of BCVA at the end of treatment.

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