ArticleGraefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie2026
Additive benefit of scleral buckling in primary rhegmatogenous retinal detachment repair with silicone oil.
Article in Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeTo evaluate surgical and visual outcomes in primary rhegmatogenous retinal detachment (RRD) repair with silicone oil, comparing cases with and without adjunctive scleral buckling (SB).
methodsThis retrospective cohort study included eyes that underwent pars plana vitrectomy (PPV) with silicone oil as the initial surgical intervention for primary RRD at Sheba Medical Center (2010-2022). Eyes were grouped based on SB use. Primary outcomes included single-surgery anatomical success (SSAS) and final best-corrected visual acuity. Secondary outcomes included time to reoperation, failure pattern, silicone oil removal, long-term silicone oil retention, and secondary glaucoma.
resultsAmong 1,900 eyes that underwent vitrectomy for rhegmatogenous retinal detachment during the study period, 107 eyes met inclusion criteria: 28 underwent SB + PPV and 79 underwent PPV alone. The SB + PPV group was younger than the PPV-only group and had a higher prevalence of giant retinal tears and a greater number of retinal tears. Single-surgery anatomical success was similar between groups: 14/28 eyes (50.0%) in the SB + PPV group and 39/79 eyes (49.3%) in the PPV-only group. Among eyes requiring reoperation, the interval to second surgery was numerically longer in the SB + PPV group than in the PPV-only group (6.28 [3.73-9.10] vs. 2.84 [0.85-9.92] months; p = 0.150), while persistent and recurrent RRD patterns were similar between groups. Silicone oil removal was performed more often in the SB + PPV group (92.9% vs. 74.7%), while long-term silicone oil retention was less frequent (7.1% vs. 25.3%), although this difference did not reach conventional statistical significance. Final visual acuity was better in the SB + PPV group than in the PPV-only group (0.70 [0.44-1.30] vs. 1.30 [0.52-2.70] logMAR; p = 0.035), although visual improvement from presentation did not differ significantly between groups. Among PPV-only eyes requiring reoperation, 10/40 (25.0%) underwent secondary scleral buckling.
conclusionsDespite greater baseline complexity, adjunctive SB was associated with comparable SSAS and better final visual acuity, although visual acuity improvement from presentation did not differ significantly between groups. These findings suggest that adjunctive SB may modify the postoperative course in selected high-risk silicone oil cases, but prospective studies are needed to define which eyes benefit most.
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