[Role of segmental buckling surgery in treatment of stages B and C proliferative XXXX . A long-term follow-up].

@entity1 @entity6746 @entity1713 @entity726 @entity2296 @entity6350
BACKGROUND: The following questions should be addressed: (1) Is minimal detachment surgery justified in @entity1713 with preoperative PVR stage B or C? (2) Can this reattach the retina with stabilization or regression of PVR? MATERIALS AND METHODS: 72 @entity1713 stage B or C (38 @entity6746 ) were treated by cryopexy, segmental buckling (n = 68) or balloon (n = 4) without drainage or vitrectomy. Reoperation (n = 10) was done without cerclage or vitrectomy. The follow-up of @entity1 alive is 11 to 13 1/2 years and of all @entity1 (31 died) x 7 1/2 years. RESULTS: After the primary operation the retina was reattached in 79%, partially in 15% and detached in 6%. An "early" redetachment (< or = 6 months postoperatively) occurred in 8.3%, no redetachment > 6 months to < 9 years and "late" redetachment (9-13 1/2 years postoperatively) in 2.8%. After reoperation (n = 10) the retina was reattached in 85%, partially in 3%, and detached in 12%. 34 eyes had delayed resorption (2 weeks to 18 months) with a residual concave detachment in area of starfolds and tractions, resulting in dry starfolds or their disappearance after months. Postoperatively there were no @entity2296 , no secondary @entity726 and no phthisis bulbi. Subsequent macular pucker developed in 12 eyes, which were not treated by vitreoretinal surgery. Six months postoperatively visual acuity was: 26x 20/60-20/25; 16x 20/200-20/100; 30x < or = 20/400 which was not statistically significant different (p = 0.549) after x 7 1/2 years. CONCLUSION: Primary treatment of a @entity1713 stage B or @entity6350 with cryopexy and segmental buckling and nondrainage seems justified to test for the chance of PVR-regression. The retina was reattached in 8 of 10 @entity1 x 7 1/2 years postoperatively after primary operation without reoperation or vitrectomy and visual acuity was 20/60-20/25 in every third @entity1 , thus implying a lack of late serious complications.
