Encircling band without retinopexy in Sub-Saharan African patients with primary retinal detachment, unvisualized breaks, and no posterior vitreous detachment.

PURPOSE: To report anatomical success rates and functional outcomes of 360-degree scleral buckling without retinopexy for cases of primary rhegmatogenous retinal detachment in Sub-Saharan African patients with undetectable retinal breaks and no posterior vitreous detachment. DESIGN: This is a retrospective, consecutive, interventional case series. METHODS: Surgery consisted of placing a narrow encircling band with 4 scleral belt loops 16mm posterior to the limbus. The band was then tightened, aiming for a 10-mm shortening of the buckle. RESULTS: A total of 19 eyes of 18 patients were included. The mean age at presentation was 40.2±19.8 years (range: 8-70). The mean follow-up was 17.3±8.8 months. Seventy-five percent of eyes were phakic, 15% were pseudophakic, and 10% were aphakic. At 2 months, 79% of eyes had full anatomical re-attachment with one surgery. Four eyes had persistent retinal detachment following surgery and underwent pars plana vitrectomy and silicone oil tamponade. After repeated surgery, the final re-attachment rate, excluding cases with silicone oil in situ, rose to 84%. Mean postoperative vision improved from 1.9±0.3 logMAR to 0.9±0.4 logMAR. Complications were mainly related to subretinal fluid drainage, consisting of one case with vitreous hemorrhage and another with subretinal hemorrhage. CONCLUSION: Primary encircling band surgery is a feasible option with an acceptable single-operation success rate for primary retinal detachment with undetectable breaks and no posterior vitreous detachment when primary vitrectomy surgery is expected to be difficult.