The surgical outcome of the modified transconjunctival technique for minimal segmental buckling on rhegmatogenous retinal detachment / 中华眼底病杂志

ABSTRACT

Objective To observe the surgical outcome of the modified transconjunctival technique for minimal segmental buckling on rhegmatogenous retinal detachment (RRD).Methods This is a retrospective case series.Seventy-six patients (78 eyes) with uncomplicated RRD who underwent the modified transconjunctival technique for minimal segmental buckling were enrolled in this study.There were 41 male (42 eyes) and 35 female (36 eyes).The average age was (33.9± 15.6) years.Best corrected vision acuity (BCVA),fundus examination with three-mirrors lens,ocular B ultrasound,optical coherence tomography (OCT) were performed in all patients.BCVA was examined through Standard logarithmic visual acuity chart and transferred to logMAR vision for statistical analysis.The logMAR BCVA was 0.88± 0.88.The technique was successfully performed in all 78 eyes.After transconjunctival location of the retinal break was made,a 5 to 6 mm radial conjunctival incision was performed corresponding to the retinal break without cutting the limbal conjunctiva-Tenon's capsule.After cryopexy,a minimal explant was fixed with one to two sutures through the conjunctival opening,expanded by a pediatric speculum.BCVA,intraocular pressure,tear film stability,conjunctival recovery and retinal reattachment were collected 1 week,1 month,3 months,6 months after surgery.Results One week after surgery,retinal reattachments were achieved in 77 of 78 (98.7％) eyes and 1 eye (1.3％) received vitrectomy.Compared before surgery,the logMAR BCVA improved to 0.44± 0.41,with significant difference (t=3.092,P＜0.01).Conjunctival incision tear occurred in 1 eye.Subretinal hemorrhage occurred in 5 eyes during subretinal fluid drainage procedure.Subretinal hemorrhage occurred in 5 eyes during subretinal fluid drainage procedure.Hemorrhage was absorbed in 2 of the 5 eyes at 3 months after surgery and absorbed in all 5 eyes at 6 months after surgery.Subretinal fluid occurred in 10 eyes at 1 week after surgery and be absorbed completely at 6 months after surgery.Tear film stability improved to preoperative lever at 1 week after surgery.Less change in corneal and conjunctival sensitivity was observed in all eyes.No other surgical complications were observed within the follow-up period,such as scleral perforation,explant extrusion,diplopia or infection.Conclusions The modified transconjunctival technique for minimal segmental buckling minimizes the damage to conjunctiva without reducing the retinal reattachment rate.It can effectively treat uncomplicated RRD with preserving an intact limbal conjunctiva and rapid tear film stability recovery.