Encircling scleral buckling with inferior indentation for recurrent retinal detachment in highly myopic eyes

Purpose: To report on the use of scleral buckling (SB) alone or associated to pars plana vitrectomy (PPV) for the treatment of recurrent retinal detachment in highly myopic eyes with axial length >26.5 mm. Methods: Single-surgeon, retrospective consecutive operative series consisting of 255 eyes of 237 highly myopic patients suffering recurrent retinal detachment after primary SB (40%), primary PPV (40%), and multiple surgery (20%). Included eyes underwent either a 6-mm encircling band associated to a 6-mm inferior buckle wedge-shaped or 2.5 mm band and 15 mm inferior buckle. Results: Overall 88% of sample population had an attached retina after 1 surgery (90% in the post-SB group, 90% in the post-PPV group, and 85% in the post-multiple surgery group). Visual acuity results were less encouraging with a mean 20/60 visual acuity in the post-SB group and 20/200 in both post-PPV and post-multiple surgery groups. Conclusion: Encircling SB explants with extensive inferior indentation can be a valuable adjunct to PPV, membrane peeling, and silicone oil tamponade in the treatment of recurrent retinal detachment in highly myopic eyes. Although anatomical success rate is increasingly high, vision is often disappointing.