Modified external needle subretinal fluid drainage in scleral buckling: A retrospective, consecutive, single-surgeon study

This study aimed to investigate the visual and anatomical outcomes and complications during and after scleral buckling (SB) surgery using a modified external needle subretinal fluid drainage (SRFD). In a retrospective interventional case series, consecutive patients who had undergone SB surgery using modified external needle SRFD, from April 2017 through March 2019, at a university hospital, were included. SRFD was performed with a 27-gauge 5/8-inch insulin needle passing bevel up through the sclera and choroid to the subretinal fluid in the bed of the buckle and by gently pulling back out of the entrance site after feeling the resistance of sclera. Anatomical attachment and visual outcome were assessed. The study included 28 eyes from 28 patients with an average age of 51.6 ± 12.9 years. Twenty-four patients (85.7%) were male. The average follow-up time was 8 ± 6.5 months. The average extent of retinal detachment was 4.75 ± 1.75. In 24 eyes (85.7%), the retina was attached after SB. Four patients underwent pars plana vitrectomy and silicone oil injection due to failed SB. The final retinal reattachment rate was 96.4%. The mean preoperative vision of patients was 0.73 ± 0.7, which was improved to 0.61 ± 0.69 logarithm of the minimum angle of resolution. The mean postoperative best-corrected visual acuity was statistically worse in patients with macular status OFF than partially OFF and ON, respectively. The present study showed SB's favorable visual and anatomical results using "modified external needle subretinal fluid drainage" with low intra- and postoperative complications. Moreover, this method has a shorter learning curve.