Long-term complications of surgical procedures for pseudophakic retinal detachment

Purpose: This study aimed to evaluate and compare the long-term surgical complications of scleral buckling (SB), pars plana vitrectomy (PPV), and their combination in pseudophakic retinal detachment (PRD). Methods: This retrospective study included 127 patients who were operated with PRD diagnosis and followed-up for at least 6 months. The patients were divided into 4 groups: Group 1 included cases undergoing SB surgery (n=31), Group 2 included cases undergoing PPV with perfluoropropane (C3F8) gas (PPV+Gas) (n=36), Group 3 included cases undergoing PPV with silicone oil (PPV+Silicone) (n=40), and Group 4 included cases undergoing PPV together with SB (SB+PPV) (n=20). The long-term postoperative complications including epiretinal membrane (ERM), cystoid macular edema (CME), persistent intraocular pressure (IOP) elevation, proliferative vitreoretinopathy (PVR), anisometropia, extraocular muscle (EOM) dysfunction/diplopia, and macular hole were assessed and compared. Results: The mean follow-up duration of the study population was 34.8 ± 17.9 months. No significant differences were noted among the groups regarding the frequency of ERM, CME, persistent IOP elevation, and PVR (P>0.05). The frequency of anisometropia was significantly higher in the SB and SB+PPV groups than in the other groups (P<0.001). EOM dysfunction was observed only in 2 (6.5%) patients in the SB group. Conclusions: The frequencies of many longterm surgical complications following SB, PPV (gas or silicone oil) or combined surgical procedures were similar. SB unfavorably influences functional vision since it is associated with increased risk of anisometropia and EOM dysfunction. Therefore, potential risk of development of such complications should be considered while preferring SB or combined procedure.