Objective: To investigate longstanding or chronic retinal detachments (RDs) with subretinal strands and their clinical features and therapeutic effects using conventional retinal surgery.
Design: Retrospective, consecutive, noncomparative case series.
Participants: Cases of 36 patients (40 eyes) with longstanding RD and subretinal proliferation who had undergone scleral buckling or encircling procedures between January 1, 1995 and October 31, 2003 at one institution were reviewed.
Methods: A retrospective analysis of the patient data was conducted from the medical records.
Main outcome measures: Visual acuity (VA) and postoperative anatomic retinal reattachment at the final follow-up visit between 3 and 24 months (mean, 6.9).
Results: Forty eyes with an RD (mean duration, 13.8 months) treated with scleral encircling and buckling had a 90% cure rate after one surgery. The VA levels increased in 77.5% of eyes to over 5/100 at the final follow-up visit. Longstanding or chronic RD with subretinal proliferation had subretinal proliferative strands (i.e., a shallow RD) and a smooth atrophic detached retina, not a thickened retina.
Conclusions: Our results suggest that scleral encircling and buckling can be used in most patients with a longstanding RD. The chronic pathologic course of longstanding rhegmatogenous RD should be considered before treatment.