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Comment on: ‘Noncryopexy versus cryopexy treatment during scleral buckling: a systematic review and meta-analysis’

Eye volume 39, page 2839 (2025)Cite this article

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We read with interest the systematic review and meta-analysis by Chen et al. [1] showing that similar outcomes were noted postoperatively no matter whether retinopexy was performed in combination with scleral buckling or not. The authors observed similar reattachment rate, final VA and complication rates between the two groups.

The authors agree with the hypothesis that buckle placement is a permanent procedure and therefore its effect on retinal re-attachment is a permanent one. However, both clinical practice and literature have highlighted the fact that buckle removal may be required on several occasions for different indications [2,3,4]. Some common risk factors include exposed scleral buckle and infection, diplopia, patient discomfort or other ocular procedures [2,3,4]. While buckle removal may be a safe procedure if adequate retinopexy has been performed before, it is likely that buckle removal in non-retinopexy cases will result in retinal break re-opening and retinal re-detachment.

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References

  1. Chen KY, Su YC, Hsu SM. Noncryopexy versus cryopexy treatment during scleral buckling: a systematic review and meta-analysis. Eye. 2025;39:1292–300.

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  2. Covert DJ, Wirostko WJ, Han DP, Lindgren KE, Hammersley JA, Connor TB, et al. Risk factors for scleral buckle removal: a matched, case-control study. Am J Ophthalmol. 2008;146:434–9.

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  3. Patel P, Heo JY, Shepherd EA, Chaturvedi V. Scleral buckle removal: long-term patient outcomes. Ophthalmol Retin. 2024;8:3–9.

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  4. Eshraghi, H, Prenner, JL, Zhang, R, Roth, DB, Wheatley, HM, Fine, HF, et al. Scleral buckle removal: indications, timing, complications, and long-term outcomes. Ophthalmic Surg Lasers Imaging Retin. 2021;52:138–44.

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Authors and Affiliations

  1. Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, UK

    Nikolaos Dervenis

  2. Moorfields Eye Hospital, London, UK

    Panagiotis Dervenis

Authors
  1. Nikolaos Dervenis
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  2. Panagiotis Dervenis
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ND: paper conception, manuscript preparation. PD: critical review of manuscript.

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Correspondence to Nikolaos Dervenis.

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Dervenis, N., Dervenis, P. Comment on: ‘Noncryopexy versus cryopexy treatment during scleral buckling: a systematic review and meta-analysis’. Eye 39, 2839 (2025). https://doi.org/10.1038/s41433-025-03976-y

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