Indications and Outcome of Scleral Buckle Surgery in Rhegmatogeneous Retina Detachment at the Pcea Kikuyu Hospital-eye Unit

Abstract

Background: Scleral buckling is one of the preferred surgical techniques for RRD repair at KEU. Beside the fact that this technique has been used for many years in this center, the outcomes are unknown and worldwide studies have shown a high success rate and improvement on visual acuity after surgery. Objective: To identify the indications and outcome of scleral buckle surgery in RRD at the KEU. Study design: Retrospective case series Methods: In this study 75 RRD cases that underwent scleral buckling at KEU from 1st January 2012 to 31stDecember 2017 were identified and their social demographic data, the indication for surgery as well as the outcome measures in terms of BCVA and retinal reattachment at 6 months were entered into a data abstraction tool, then analysed using SPSS version 23.0. Factors associated with re-detachments were determined using chi square. Results: Seventy-five (75) eyes of 73 patients were analysed but, only 30(40%) patients had 6 months follow up. The median age was 31 (IQR 22-46) years. Majority of patients (61.3%) were males, and right eye was involved in 62.7% of the cases. The mean duration of symptoms experienced prior to presentation was 35.6 (SD ± 30.2) days. In this study scleral buckling was done in 94.7% phakic eyes with inferior RRD in 72% without or with mild PVR associated with macula on in 98.7% cases. Less than 3 breaks were identified in 70.4% cases, associated with atrophic holes in 70.7% of cases. The final anatomical success rate was 96.7% at 6 months. The visual outcome improved in 19 (63.3%) eyes by more than 2 Snellen lines. In this study only 6.7% of eyes had re-detachment but no factors were identified to be associated with redetachments. Conclusion: Scleral buckling is safe and effective for uncomplicated RRD. Appropriate training of SB surgery for RRD is necessary and justified in view of the favourable results especially in phakic patients