Scleral Imbrication Sutures Provide Temporary or Sustained Vitreous Base Indentation as an Adjuvant to Pars Plana Vitrectomy for Retinal Detachment Repair

Abstract

Purpose: To analyze vitreous base indentation achieved with absorbable vs permanent scleral imbrication sutures during retinal detachment repair. Methods: This retrospective, consecutive case series included patients who underwent scleral imbrication sutures with pars plana vitrectomy (PPV) for primary rhegmatogenous retinal detachment (RRD) repair. Single-surgery anatomic success rate and visual acuity (VA) were assessed at 6 to 9 months postoperatively. Scleral indentation was measured by B-scan ultrasonography more than 6 weeks after surgery. Results: Sixteen patients were included. The single-surgery anatomic success rate was 88% (14 of 16) at 6 months. Vitreous base indentation greater than 2 mm, initially present in all quadrants, persisted beyond 6 weeks in 100% (13 of 13) of quadrants with polyester (Mersilene) scleral imbrication sutures and in 14% (2 of 14) with polyglactin 910 (Vicryl) scleral imbrication sutures. Median VA improved from baseline 0.36 logMAR (interquartile range [IQR], 0 to 1.15) to 0.18 logMAR (IQR, 0.01 to 0.51) postoperatively. Conclusions: Scleral imbrication sutures can produce either temporary or sustained vitreous base indentation. They may serve as a useful adjuvant to PPV for primary RRD repair when avoidance of a buckle element is desired.