Subfoveal Choroidal Thickness After Combined Pars Plana Vitrectomy and 360° Encircling Scleral Buckling for Primary Rhegmatogenous Retinal Detachment: A Descriptive Swept-Source OCT Analysis
Combined PPV with 360° encircling scleral buckling shows high success rates and significant visual recovery, but does not appear to cause a sustained increase in subfoveal choroidal thickness.
Where it sits
this study against the rest of the ss-31 corpusSummary and findings
This study measured postoperative subfoveal choroidal thickness (SFCT) after combined pars plana vitrectomy and 360° encircling scleral buckling in 32 patients with primary rhegmatogenous retinal detachment. The mean SFCT was 235 ± 60 µm at 1 month postoperatively, compared to 220 ± 55 µm in fellow eyes, with no significant difference (P = .18). Visual acuity improved significantly from logMAR 1.0 to 0.3 (P < .001).
Abstract
<title>Abstract</title> <p>Purpose: To describe postoperative subfoveal choroidal thickness (SFCT) after combined pars plana vitrectomy (PPV) and 360° encircling scleral buckling (SB) for primary rhegmatogenous retinal detachment (RRD), using swept-source optical coherence tomography (SS-OCT), and to report the associated anatomical and visual outcomes. <h4>Design:</h4> Retrospective, observational case series at a tertiary referral center. Participants: Thirty-two eyes of 32 consecutive patients undergoing combined PPV and 360° encircling SB as primary repair for RRD between January 2020 and December 2023. <h4>Methods:</h4> All eyes were treated with a standardized combined technique. SS-OCT (DRI-OCT Triton) was performed at approximately 1 month and 3–6 months postoperatively. SFCT was measured manually at the foveal center and compared with unoperated fellow eyes. Best-corrected visual acuity (BCVA), residual subfoveal subretinal fluid (SRF), and ellipsoid zone integrity were also assessed. Main Outcome Measures: Postoperative SFCT in operated versus fellow eyes, single-operation and final anatomical success, and change in BCVA. <h4>Results:</h4> Single-operation reattachment was 100% at 1 month; one eye developed recurrent RRD, yielding a true single-operation success rate of 97% (31/32) and 100% final anatomical success. Mean BCVA improved from logMAR 1.0 to 0.3 (P < .001), with better outcomes in macula-on than macula-off eyes (logMAR 0.1 vs 0.4; P = .02). Residual subfoveal SRF was present in 10 eyes (31%) at 1 month and resolved in 8 by 3–6 months. Mean 1-month SFCT was 235 ± 60 µm in operated eyes versus 220 ± 55 µm in fellow eyes, a nonsignificant difference (P = .18); given the sample size, the study was likely underpowered to detect a difference of this magnitude. Eyes with persistent SRF showed a nonsignificant trend toward greater SFCT (~260 vs ~225 µm). By final follow-up, SFCT in operated eyes decreased to approximately 225 µm, approaching fellow-eye values. No choroidal detachment or buckle-related complications occurred. <h4>Conclusions:</h4> Combined PPV with a 360° encircling scleral buckle was a highly effective repair for primary RRD, with excellent single-operation success and favorable visual recovery. On descriptive SS-OCT analysis, the combined technique was not associated with a sustained increase in subfoveal choroidal thickness. Given the absence of a control group and the limited sample, these findings are hypothesis-generating and warrant confirmation in larger prospective studies.</p>
Background
Not reported in abstract.
Methods
Not reported in abstract.
Results
Not reported in abstract.
Interpretation
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Key findings
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Limitations
- Not reported in abstract.