Comparative Study Of Scleral Buckling Versus23G-Vitrectomy For Superior Bullous Rhegmatogenous Retinal Detachment

Objective:To compare the therapeutic effects of scleral buckling combined with intravitreal injection of air and23G-transconjunctival sutureless vitrectomy for the treatment of superior bullous rhegmatogenous retinal detachment.Methods:A group of sequential superior bullous rhegmatogenous retinal detachment43cases from July2010to January2012were divided into SB group (23cases) and23G-TSV group(20cases) randomly. All the surgeries were operated by the same ophthalmologist. Anatomic success rate, best corrected visual acuity (BCVA), refractive change of cornea, patient’s comfort and complications were observed.Results:SB group’s single-surgery anatomic success was95.7%while23G-TSV group’s was100%.Both Final anatomic success rates were100%.There was significant difference in neither single-surgery anatomic success nor final anatomic success rate (P>0.05).The BCVA preoperation had no significant difference between the two groups (P>0.05). SB group’s BCVA was better than23G-TSV group’s at1week postoperation (P<0.05), however, there was no significant difference at2weeks, lmonth,2months and3months postoperation (all P>0.05). SB group’s Sim K was bigger than23G-TSV group’s at1week, lmonth and2months postoperation (all P<0.05), however, there was no significant difference at3months postoperation (P>0.05).SB group’s Sim K1-K2was bigger than23G-TSV group’s at1week, lmonth,2months and3months postoperation (all P0.05).SB group’s discomfort brought about by the necessary to keep certain posture was significantly less serious than23G-TSV group’s at1day>3daysN1week and2weeks postoperation (all P<0.05), however, there was no significant difference at lmonth and3months postoperation (all P>0.05). SB group’s discomforts connected with ophthalmalgia, dacryorrhea and sensations of foreign body were significantly more serious than23G-TSV group’s at1day>3days、1week and2weeks postoperation (all P<0.05), however, there were no significant differences at lmonth and3months postoperation (all P>0.05). The rate of complicated cataract and ocular hypertension in SB group were significantly lower than those in23G-TSV group (all P<0.05), however, the rate of submacular fluid in SB group was significantly higher than that in23G-TSV group (P<0.05)Conclusion:Both scleral buckling combined with intravitreal injection of air and23G-transconjunctival sutureless vitrectomy are efficacious to treat superior bullous rhegmatogenous retinal detachment. The former has the advantage of less discomfort brought about by the necessary to keep certain posture and lower risk to develop complicated cataract and ocular hypertension while the latter has the advantage of causing less change in cornea refractive satus and less discomforts connected with ophthalmalgia, dacryorrhea and sensations of foreign body in the early stage postoperation and lower risk to occur submacular fluid postoperation.