Usefulness of a standardized scleral buckling technique for primary rhegmatogenous retinal detachment

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Abstract

Purpose Rhegmatogenous retinal detachment (RRD) requires timely treatment to prevent vision loss. Buckling surgery is a vital intervention; however, surgeon proficiency in buckling surgery is declining, and efforts are needed to preserve it. This study evaluated the efficacy of a standardized buckling surgical technique for primary RRD. Methods In total, 69 eyes were included. The technique involved placing #287 silicone tires in the retinal break regions with a 9–10-mm mattress suture positioned using the posterior edge of the rectus muscle insertion as a reference point. Circumferential buckling was performed using a silicone band (#240) and silicone sleeve (#270). Results The 6-month follow-up showed an initial anatomical success rate of 92.8%, which reached 100% at the final follow-up. The mean best-corrected visual acuity was 0.16±0.45 pre-operation and 0.05±0.24 at the 6-month follow-up (p=0.05). Conclusion This technique utilizes the characteristics of the anatomical positional relationships between the scleral insertion of the lateral rectus muscle, which is reported to overlap with the vitreous base insertion, and the ora serrata and shows promise in identifying retinal breaks and determining buckling positions, indicating its potential effectiveness for the treatment of RRD. The favorable anatomical and visual outcomes support the potential usefulness of this technique in buckling surgeries.

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Imai, H., Kishi, M., Sotani, Y., Yamada, H., Matsumiya, W., Miki, A., … Nakamura, M. (2025). Usefulness of a standardized scleral buckling technique for primary rhegmatogenous retinal detachment. PLoS ONE, 20(5 May). https://doi.org/10.1371/journal.pone.0323881

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