SCLERAL BUCKLING FOR RETINAL-DETACHMENT - PREDICTORS FOR ANATOMIC FAILURE

Purpose: The influence of various preoperative, intraoperative, and po stoperative factors on retinal reattachment after scleral buckling was examined. Methods: A study of 601 eyes of 577 consecutive patients wh o underwent conventional scleral buckling procedures was conducted. Mu ltiple logistic regression analysis was used to determine the independ ent influence of each variable on anatomic failure. Results: Anatomic reattachment of the retina was achieved in 86% of eyes after a single procedure, and in 90% of eyes after a second surgical procedure, with a mean follow-up period of 5.27 months (range, 2-29 months). Factors p redictive of poor anatomic success (P < 0.05) included preoperative ch oroidal detachment and significant vitreous opacification; circumferen tial buckle extent of more than two quadrants and intravitreal injecti on of air or fluid intraoperatively; and postoperative occurrence of s terile vitritis. Conclusion: Breakdown of the blood-retinal barrier le ading to cellular migration and proliferation is considered to be pred ictive of anatomic failure after scleral buckling procedures.