Effective Treatments for Retinal Detachment: Scleral Buckle, Vitrectomy, and Pneumatic Retinopexy for Optimal Visual Success

Retinal detachment is a serious ophthalmological condition that can lead to vision loss if not treated appropriately. This phenomenon occurs when the retina separates from the underlying retinal pigment epithelium, disrupting the supply of essential nutrients and oxygen. There are several types of retinal detachment, with rhegmatogenous retinal detachment being the most common. This type is characterized by the presence of a tear in the retina that allows fluid from the vitreous cavity to enter the subretinal space, causing the retina to detach.

The treatment of retinal detachment has evolved significantly, and there are currently several surgical options available, including pneumatic retinopexy, vitrectomy, and scleral buckle surgery. Each of these techniques has its own indications, advantages, and limitations, and the choice of treatment depends on factors such as the location and size of the tear, as well as the characteristics of the patient.

Diving Deeper into Treatments

Pneumatic retinopexy is a minimally invasive procedure that involves the injection of intraocular gas to push the retina back to its original position. This method is particularly useful in cases of simple detachments with localized tears in the upper part of the retina. Although it is less invasive, its visual success rate may be lower compared to other techniques, and it may require a second intervention in some cases [1].

Vitrectomy is a more complex technique that involves the removal of the vitreous humor to relieve traction on the retina. This procedure is particularly effective in cases of more complicated detachments or when there is the presence of vitreoretinal proliferation. Vitrectomy has been shown to be highly effective, with a high rate of anatomical and visual success, although it may be associated with a higher risk of complications such as cataract development [2].

Finally, scleral buckle surgery involves placing a silicone band around the eye to reduce traction on the retina. This method has been a cornerstone in the treatment of retinal detachment for decades and remains a viable option, especially in cases of primary detachments. Although its use has declined with the popularity of vitrectomy, scleral buckle surgery continues to offer comparable anatomical and functional outcomes [3].

Conclusions

The treatment of retinal detachment requires careful evaluation of each case to select the most appropriate technique. Pneumatic retinopexy, vitrectomy, and scleral buckle surgery are valid options, each with its own indications and expected outcomes. The choice of treatment should be based on the specific characteristics of the detachment and the surgeon's experience. Despite advancements in surgical techniques, it is crucial to continue researching to improve visual outcomes and the quality of life for patients [4].

Referencias

• [1] Review and analysis of history and utilization of pneumatic retinopexy after pneumatic retinopexy versus vitrectomy for the management of primary rhegmatogenous retinal detachment outcomes randomized trial (PIVOT).
• [2] Pars plana vitrectomy, scleral buckle, and pneumatic retinopexy for the management of rhegmatogenous retinal detachment: a meta-analysis.
• [3] Retinal detachment.
• [4] Pneumatic retinopexy: an update.

Created 6/1/2025