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      Scleral buckle surgery in Ghana: a decade comparison of the anatomic and visual outcome

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          Abstract

          Purpose

          To compare the anatomic and visual outcome of scleral buckle (SB) surgery in Korle Bu Teaching Hospital between 2002 and 2005 and 2011 and 2014.

          Materials and methods

          In this retrospective comparative study, the medical records of patients who have undergone SB for rhegmatogenous retinal detachment from January 2002 to December 2005 (group A) and from January 2011 to December 2014 (group B) in Korle Bu Teaching Hospital were examined. The clinical history, surgical techniques, and outcomes of treatment were analyzed. The main outcome measures were primary anatomic success (retina reattached for at least 3 months postoperatively after a single procedure), overall anatomic success (combined primary anatomic success and success following revision of SB with at least 3 months follow-up), mean postoperative best-corrected visual acuity (BCVA), and complications.

          Results

          One hundred fifty-eight eyes (71 eyes in group A and 87 eyes in group B) were treated with SB in this study. The mean duration of rhegmatogenous retinal detachment was 105.5 days. Thirty-four (21.8%) of fellow eyes had BCVA worse than 6/60 at presentation. The primary anatomic success was comparable between the two groups; 70% in group A and 67.9% in group B ( P=0.79). The overall anatomic success was also comparable between the two groups (76.7% in group A vs 79.8% in group B) ( P=0.788). The mean postoperative BCVA in logMAR was significantly better than the mean preoperative BCVA ( P<0.0001). Group B had significantly better mean BCVA ( P=0.002) and longer duration of follow-up ( P<0.0001) compared with group A at the last follow-up visit.

          Conclusion

          The anatomic success of SB between the two time periods was comparable. A longer postoperative duration of follow-up was associated with a better visual outcome after SB.

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          Most cited references28

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          Proliferative vitreoretinopathy: an overview.

          J. Pastor-Jimeno (2015)
          Proliferative vitreoretinopathy (PVR) is still the most common cause of failure of surgery for rhegmatogenous retinal detachment, despite the substantial effort that has been devoted to better understanding and managing this condition during the past 25 years. Basic research has indicated that PVR represents scarring, the end stage of the wound-healing process that occurs after retinal detachment surgery. Medical treatment has been directed toward preventing inflammation, the first phase of the wound healing process, and inhibiting cell proliferation, the second phase. The 1983 Retina Society classification was modified in 1989 by the Silicone Study Group, whose classification differentiates between posterior and anterior forms of PVR and recognizes three patterns of proliferation: diffuse, focal, and subretinal. The anterior form has a worse prognosis than the posterior form, and its treatment requires more complex surgical procedures. In this review, risk factors and pathobiology of PVR are discussed, and management of PVR of various degrees of severity are considered.
          Article 0 comments Cited 73 times – based on 0 reviews     Review now
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            Visual recovery after macula-off retinal detachment.

            Alexander Ross (2002)
            With modern surgical techniques to repair retinal detachments, a greater than 90% primary anatomic success rate can be expected. Despite this high level of anatomic success, visual results remain compromised mainly because of permanent functional damage once the macula becomes detached. The most important predictor of visual recovery after retinal detachment surgery is preoperative visual acuity. Preoperative acuity appears to be directly related to the height of macular detachment. Shorter duration of detachment and younger age are also important in visual recovery. This paper will review the current literature that helps to improve our understanding of visual recovery after macula-off retinal detachments.
            Article 0 comments Cited 38 times – based on 0 reviews     Review now
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              Visual recovery after scleral buckling procedure for retinal detachment.

              William Smiddy, A Venkatraman, Alberto Salicone … (2006)
              To evaluate prognostic factors for visual and anatomic outcomes, including complications after scleral buckling procedure (SBP) for primary rhegmatogenous retinal detachments. Retrospective, consecutive, nonrandomized, comparative interventional case series. Patients undergoing SBP for primary rhegmatogenous retinal detachment performed by a single surgeon. The patients' medical records were reviewed. Preoperative and intraoperative factors analyzed for their association with visual acuity and anatomic outcomes included macular detachment, duration of macular detachment, preoperative visual acuity, lens status, refractive error, extent of detachment, number of breaks, internal gas tamponade, and drainage of the subretinal fluid. Secondary outcomes included frequency of further surgery, complications, and fellow eye retinal detachment. The fellow eye of the patients was excluded from consideration of prognostic factors. Best-corrected visual acuity at 2 months and at final follow-up examination as well as anatomic factors including retinal reattachment at 1 day, 2 months, and last follow-up examination. There were 672 patients studied, including 457 (68%) with macular detachment. The use of gas, drainage of subretinal fluid, and lens status did not influence final anatomic or visual results. Macular detachment was the most important prognostic factor for anatomic (P = 0.031) and visual acuity success (P<0.001). Better preoperative visual acuity (P<0.001), fewer quadrants involved by the detachment (P<0.001), and lack of high myopia (P = 0.001) were important positive prognostic factors for visual acuity. The duration of macular detachment was not of prognostic value up to 30 days' duration. Visual recovery after retinal reattachment was most dependent on macular involvement. Duration of macular detachment had surprisingly little influence on postoperative visual acuity.
              Article 0 comments Cited 34 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Clin Ophthalmol
                Journal ID (iso-abbrev): Clin Ophthalmol
                Journal ID (publisher-id): Clinical Ophthalmology
                Title: Clinical Ophthalmology (Auckland, N.Z.)
                Publisher: Dove Medical Press
                ISSN (Print): 1177-5467
                ISSN (Electronic): 1177-5483
                Publication date Collection: 2018
                Publication date (Electronic): 05 December 2018
                Volume: 12
                Pages: 2509-2517
                Affiliations
                [1 ]Department of Surgery, School of Medicine and Dentistry, College of Health Sciences, University of Ghana, Accra, Ghana, zebaimoro2000@ 123456yahoo.com
                [2 ]Eye Centre, Korle Bu Teaching Hospital, Accra, Ghana, zebaimoro2000@ 123456yahoo.com
                [3 ]Srimati Kanuri Santhamma Centre for Vitreo-Retinal Diseases, KAR Campus, L V Prasad Eye Institute, Hyderabad, Telangana, India
                Author notes
                Correspondence: Imoro Z Braimah, Department of Surgery, School of Medicine and Dentistry, College of Health Sciences, University of Ghana, PO Box 4236, Accra, GA-320, Ghana, Tel +233 20 630 1353, Email zebaimoro2000@ 123456yahoo.com
                Article
                Publisher ID: opth-12-2509
                DOI: 10.2147/OPTH.S184047
                PMC ID: 6287668
                SO-VID: 5fbe5fe6-dc1b-44eb-a7de-36213dee6f5e
                Copyright © © 2018 Braimah et al. This work is published and licensed by Dove Medical Press Limited
                License:

                The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.

                History
                Categories
                Subject: Review

                ScienceOpen disciplines: Ophthalmology & Optometry
                Keywords: rhegmatogenous retinal detachment,scleral buckle surgery,laser retinopexy,cryotherapy,ghana
                Data availability:
                ScienceOpen disciplines: Ophthalmology & Optometry
                Keywords: rhegmatogenous retinal detachment, scleral buckle surgery, laser retinopexy, cryotherapy, ghana

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