RESULTS OF RHEGMATOGENOUS RETINAL-DETACHMENT REPAIR IN CYTOMEGALOVIRUS RETINITIS WITH AND WITHOUT SCLERAL BUCKLING

Purpose: To determine if scleral buckling is of any benefit in surgica l repair of cytomegalovirus (CMV)-associated retinal detachment if com bined with vitrectomy, silicone oil, and inferior midperipheral endola ser. Materials and Methods: Twenty-two consecutive eyes with CMV-assoc iated retinal detachments were repaired with vitrectomy and endolaser to all breaks and to the inferior midperipheral retina using silicone oil without scleral buckling (group 1, control group) between July 198 7 and May 1992. Results were compared with another series of 56 consec utive eyes undergoing vitrectomy, silicone oil injection, endolaser to all breaks, and 360 degrees encircling scleral buckling (group 2, stu dy group) between June 1992 and July 1993. Results: Total retinal reat tachment rates were 84% for group 1 and 86% for group 2. Rates of macu lar reattachment were 91% for group 1 and 91% for group 2. Mean best p ostoperative refracted visual acuity was 20/66 for group 1 and 20/67 f or group 2. Median best postoperative refracted visual acuity was 20/7 4 for group 1 and 20/80 for group 2. These differences in results betw een the two groups were not statistically significant. Mean postoperat ive refractive error was +3.95 for group 1 and +4.92 for group 2. Pati ents who underwent surgery with the macula attached had a better posto perative visual outcome. Conclusion: Scleral buckling may not be neces sary in CMV-related retinal detachment if repaired with vitrectomy, si licone oil, and inferior midperipheral endolaser. Elimination of scler al buckling may reduce intraoperative time, patient morbidity, and the risk of an accidental needle stick. Patients with macula-on retinal d etachments also should be considered for surgery before macular detach ment.