Scleral buckle for progressive symptomatic retinal detachment complicating retinoschisis versus primary rhegmatogenous retinal detachment

Objective: To compare the functional and anatomic outcomes of encircling scleral buckle placement for the repair of progressive symptomatic retinal detachment complicating retinoschisis (PSRDCR) with outer-layer breaks (OLBs) posterior to the equator versus primary rhegmatogenous retinal detachment (RRD). Design: Retrospective comparative case series. Participants: Thirty-seven patients with PSRDCR with OLBs posterior to the equator (group A) and 703 patients with primary RRD (group B). Methods: All eyes were treated with an encircling scleral silicone band (style 240). External drainage of subretinal and retinoschisis cavity fluid and cryopexy or laser photocoagulation around the tears and the OLBs were performed in all eyes. Best-corrected visual acuity at 6 months postoperatively and final retinal reattachment rate were analyzed. Results: There was no statistically significant difference between the 2 groups in terms of patient age, gender, percentage of retinal detachments that were macula-off (p = 0.241), and preoperative best-corrected Snellen visual acuity (p = 0.927). Best-corrected Snellen visual acuity at 6 months postoperatively was ≤ 20/100 in 35% of eyes, 20/100-20/50 in 14% of eyes, and ≥ 20/40 in 51% of eyes in group A versus ≤ 20/100 in 37% of eyes, 20/100-20/50 in 33% of eyes, and ≥ 20/40 in 30% of eyes in group B (p = 0.12); the final retinal reattachment rate was 97% in group A versus 98% in group B (p = 0.77). Conclusions: Placement of an encircling scleral buckle may be an effective method to manage both PSRDCR with OLBs posterior to the equator and primary RRDs. The procedure is associated with comparable visual acuity and anatomic outcomes for both types of retinal detachment.