![]() Scleral buckling (SB) has followed a commensurate downward trend in popularity because many surgeons perceive it as more technically challenging and time-consuming. Small gauge pars plana vitrectomy (PPV) has grown in popularity such that many surgeons view it as the first-line treatment for most detachments. The approach to repairing rhegmatogenous retinal detachments (RRDs) can vary depending on features of the detachment as well as the surgeon’s comfort level. Shortening surgical time while maintaining low complication rates makes this an appropriate approach to SB, especially for vitreoretinal surgery trainees. Modified SB technique was non-inferior compared to the standard approach for anatomical and visual outcomes. Scleral perforation (2:1), vitreous hemorrhage (3:2), and transient rise of intraocular pressure (3:4) all occurred at a low and similar rate between the two groups (S:M). Controlling for preoperative BCVA on ANCOVA testing, there were no significant differences in visual improvement between the two groups. After 12 months, both groups achieved similar final best-corrected visual acuity (BCVA): 0.26 ± 0.23 and 0.23 ± 0.17 logMAR in groups S and M, respectively ( P = 0.231). Complete retinal reattachment at the end of month 12 after single surgery was 80.6% overall 77.8% (14/18) in group S and 83.3% (15/18) in group M ( P > 0.999). There were no differences in baseline patient demographics or characteristics including gender, age, lens and macular status, preoperative vision, and symptom duration. Thirty-six eyes were included in the study (18 in each arm). Patients were followed for 12 months and the primary outcomes were differences between the surgical groups in operative time, anatomical success, visual acuity, and complication rate. A large tire (276/279) was placed where preoperative retinal breaks had been localized with a 240 encircling band placed for support of the remaining retina. In the modified approach, neither intraoperative break localization nor cryopexy or subretinal fluid drainage was done. In this single-masked randomized interventional study, patients with RRDs who were eligible for SB were randomly assigned to either the standard (S) or modified (M) technique of SB. This study characterizes a novel and simplified technique for SB. Scleral buckling (SB) tends to be more challenging and time-consuming for compared to the pars plana vitrectomy for repairing rhegmatogenous retinal detachments (RRDs).
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