Retinal Displacement Following Rhegmatogenous Retinal Detachment Repair: Scleral Buckling vs Pars Plana Vitrectomy (The BEVERLEY Study).

Abstract

Purpose: To investigate the retinal displacement and metamorphopsia in patients with primary rhegmatogenous retinal detachment (RRD) treated with pars plana vitrectomy (PPV) or scleral buckling (SB).

Methods: This is a prospective non-randomized interventional study. A total of 107 patients were studied over a period of 6 months postoperatively. The vessel printing on the fundus autofluorescence (FAF) photos and the M-CHART were used to evaluate the retinal displacement and the metamorphopsia, respectively. We also assessed the vision-related quality of life, the postoperative visual acuity and the optical coherence tomographic (OCT) findings.

Results: Sixty-five male and forty-two female patients were recruited in the study. The mean age was 54.8 years (SD 14.7, range 18-82). The proportion of eyes detected with retinal displacement at six months postoperatively was significantly lower in the SB group (4.3%) than in the PPV group (30.9%) (26.6% difference, 95% CI 13.1% - 40.1%, p<0.001). The SB group had significantly lower postoperative vertical and horizontal metamorphopsia (45.5% difference, 95% CI 28.3% - 62.7% p<0.001 and 38.2% difference 95% CI 20.7 % - 55.7%, p<0.001, respectively). There was no significant difference between the two study groups regarding the vision-related quality of life (1.19 difference, 95% CI -5.76, 7.70, p=0.783) and visual acuity (0.08 difference, 95% CI 0.00, 0.17, p=0.051).

Conclusion: Although scleral buckling is not superior in visual acuity improvement and quality of life, it improves anatomical outcomes with less retinal displacement and functional outcomes with less metamorphopsia.