Mahmood Saeed, Adil Saleem, Fouzia Farhat.
Scleral buckling procedure; an experience with rhegmatogenous retinal detachment patients.
J Sheikh Zayed Med Coll Jan ;1(2):50-5.

Background: Rhegmatogenous Retinal Detachment (RDD) is the most common type of Retinal Detachment, secondary to break in neurosensory layer of retina. Objective: To determine anatomical and functional improvement and complications, in patients with RDD, treated by scleral buckling procedure. Patients and Methods: This descriptive study was conducted in Department of Ophthalmology, Jinnah Post Graduate Medical Centre, Karachi, during July 2004 to December 2005. A total of 40 patients of RRD with proliferative vitereoretinopathy (PVR) grade A and B, under went scleral buckling procedure (SBP). The patients from 5 to 55 years of age and of either sex were included in this study. In addition, patients with diabetes mellitus, coronary vascular disease and other known risk factors for surgery were excluded from the study. All of the patients had uncomplicated RRD with duration of less than three months. Patients were followed up for upto three years for anatomical and functional improvement and complications. Results: A three year follow up showed anatomical reattachment after first surgery in 77.5% (31) of the cases and after second surgery in all of the cases. Visual improvement was observed in 75% (30) of the cases while 7.5% (3) cases had worsening of vison and 17.5% (7) cases showed no improvement in their vision. Per operative complication of iatrogenic break, choroidal hemorrhage was also noticed and draining of sub-retinal fluid (SRF) in a total of 7.5% (3) cases, RD in early post-operative period was encountered in 7.5% (3) cases, due to inadequate buckling, whereas in 15% (6) cases, RD developed in late-post operative period. In two of the cases, plomb was exposed. Out of these, one developed endophthalmitis. Causes of RD in early post-operative period was missed hole in two cases, which was dealt with successfully by application of additional plomb. Conclusion: Observing the basic surgical principles and thorough pre and post operative examination of the patients, scleral buckling procedure is a safe and effective technique for uncomplicated patients of RRD.

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