Hafif Derecede Vitreus Hemorajisinin Eşlik Ettiği Retina Dekolmanının Tedavisinde Skleral Çökertme ile Primer Vitrektominin Karşılaştırılması

Objectives: The aim of this study was to compare the surgical impact of scleral buckling (SB) and pars plana vitrectomy (PPV) on the\udanatomic results and visual recovery in cases of rhegmatogenous retinal detachment with mild vitreous hemorrhage.\udMaterials and Methods: In this study, we included 78 eyes of 78 phakic patients who underwent primary surgery for rhegmatogenous\udretinal detachment complicated by mild vitreous hemorrhage (38 eyes by SB,40 eyes by PPV);all patients had been followed for longer\udthan 6 months after surgery. The surgical outcome and the rate of complications were retrospectively compared. Mann-Whitney U-test\udand chi-square test were used for the statistical analysis.\udResults: The reattachment rate after the first surgery was 78.9% (30/38) in the SB group and 95% (38/40) in the PPV group. The\uddifference between the groups was statistically significant (p=0.035). Unseen retinal breaks in 4 eyes, malpositioned buckle in 2 eyes\udand insufficient closure of the break in 2 eyes of SB cases, as well as reopening of the original break in 2 eyes of PPV cases were the causes\udof failure. Visual improvement in the PPV group was significantly better than in the SB group in the third and sixth postoperative\udmonths (p<0.001 and p=0.026, respectively). Peroperative and postoperative complications were as follows: in the SB group-subretinal\udhemorrhage (5.2%), PVR of grade B or worse (10.5%), macular pucker (7.8%), and postoperative cataract (13%); in the PPV groupiatrogenic\udbreaks (10%), lens damage (5%), PVR of grade B or worse (5%),macular pucker (5%), and postoperative cataract (35%).\udConclusion: Even though the high incidence of peroperative complications such as iatrogenic breaks or postoperative complications\udsuch as cataract formation was the major drawback, the results indicate that PPV performed to alleviate peripheral vitreoretinal tractions\udand clear vitreous hemorrhage offers better anatomic and functional results than SB in the management of rhegmatogenous retinal\uddetachment associated with mild vitreous hemorrhage. (Turk J Ophthalmol 2014; 44: 92-7