Complications associated with vortex vein damage in scleral buckling surgery for rhegmatogenous retinal detachment

Purpose: To further understand postoperative complications after vortex vei n damage during scleral buckling surgery. Methods: The records of 34 patients (34 eyes) with vortex vein damage durin g scleral buckling surgery for rhegmatogenous retinal detachment were revie wed and compared with the records of 410 eyes undergoing similar surgery wi thout vortex vein damage. Results: Postoperative complications were noted in 16 eyes (47%) of the dam aged vortex vein group. The incidence of choroidal detachment, vitreous opa cities, intraocular pressure elevation, and vitreous hemorrhage were 27%, 1 8%, 9%, and 6%, respectively, with a higher incidence than in the group wit hout vortex vein damage. Other complications included development of epiret inal membrane (9%), subretinal hemorrhage (3%), and anterior segment ischem ia (3%). Serous choroidal detachment occurred in the early postoperative da ys and subsided within 3 weeks. Vitreous opacification became marked in the later periods and continued for 2 months or longer. The incidence of posto perative choroidal detachment in the vortex vein damage group was related t o the patient's age (P =.002) and the cutting of the vortex veins (P =.048) , but was not related to preoperative conditions of retinal detachment or t he number of vortex veins damaged. All the eyes except one achieved retinal reattachment after initial surgery. Conclusions: Choroidal detachment and vitreous opacity are common after scl eral buckling surgery with vortex vein damage. Although intervention of the vortex veins during scleral buckling surgery is acceptable when performing otherwise difficult to achieve ample scleral indentation, it should be min imized to avoid increased incidence of postoperative complications. Jpn J O phthalmol 1999;43:232-238 (C) 1999 Japanese Ophthalmological Society.