Objective:
To evaluate the role and effectiveness of scleral buckling (SB) in treating phakic rhegmatogenous retinal detachment (RRD) compared to pars plana vitrectomy (PPV), highlighting its clinical significance.
Key Findings:
- Scleral buckling offers superior visual outcomes and lower cataract progression compared to PPV in phakic eyes, supported by multiple studies.
- SB achieves higher single-surgery anatomic success rates (91.7%) compared to PPV (83.1%), as evidenced by recent trials.
- Nondrainage techniques reduce the risk of serious complications and preserve refractive integrity, with specific references to studies.
Interpretation:
Despite its advantages, the use of scleral buckling has declined due to changing surgical preferences and training, raising concerns about the future availability of this technique and its impact on patient care.
Limitations:
- Declining training and expertise in scleral buckling may limit its availability for future patients.
- Certain ocular conditions, such as advanced glaucoma or severe proliferative diabetic retinopathy, may contraindicate the use of SB.
Conclusion:
Scleral buckling remains a valuable technique for treating phakic RRD, particularly in younger patients and those with chronic conditions, and should be reconsidered in surgical practice, with recommendations for training and practice integration.
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