Clinical observation of scleral buckling in the treatment of rhegmatogenous retinal detachment under surgical microscope

Objective To observe the clinical efficiency of scleral bucking surgery under the microscope for the treatment of rhegmatogenous retinal detachment(RRD). Methods The clinical data of 18 patients (20 eyes), diagnosed as RRD in the vitreoretinopathy Department of the ophthalmological Hospital of Chinese Academy of traditional Chinese medicine, from September 2016 to September 2017, were treated with scleral pressure surgery under microscope. All patients were followed up for 1~12 months, with an average of (6.1±1.2) months, observation and observation. Force, retinal reposition rate and complications. The visual acuity of the patients before and after operation was divided into three categories according to 0.30. The number and percentage of eyes were described with Kruskal-Wallis H rank sum test. Results In the cases observed in this study, the retina of the patient was completely restored without significant complications. 6 patients(6 eyes) were treated with vitreous cavity gas injection, and vitreous cavity gas was absorbed completely after 1~2 weeks. All cases were given scleral puncture drainage, and residual subretinal fluid completely subsided around 2 weeks after operation. However, 2 patients(2 eyes) were completely absorbed after six months. In addition, 4 patients(4 eyes) received laser photocoagulation around the retinal hole after operation. During the follow-up, all the retinal holes in the central lesion area were closed and the retinal reattachment rate was 100%.Visual acuity was improved in 12 patients(13 eyes) and no change in visual acuity was found in 6 patients(7 eyes). Due to scleral buckling, the shape of the eyeball changes from the original approximately spherical shape. In some cases, the diopter was changed. The visual acuity was partly improved after retinal detachment and macular reduction. The difference was statistically significant (Hc=8.62, P<0.05) after Kruskal-Wallis H. There were 4 cases(4 eyes) of postoperative mild binocular diplopia, 5~7 days after the symptoms disappeared, the eyeball movement was not limited; 13 cases(13 eyes) of conjunctival suture stimulation after the main complaint of foreign body sensation, after the dismantling suture is not unsuitable, 1 case(1 eye) of conjunctival incisional nonunion. Conclusion It′s practicable to replace traditional external surgery by external retinal detachment surgery under the microscope. With the advantages of high magnification microscope, retinal hiatus closure rate and surgical success rate can be improved, and avoiding some surgical complications. Key words: Rhegmatogenous retinal detachment; Operating microscope; Scleral bucking surgery