Maria Chiara Freno*, Maurizio Mete, Grazia Pertile (Negrar, Italy)


Small bleb-like subretinal lesions (bleb-like syndrome) have been shown to be a relatively common finding after scleral buckling (SB) for retinal detachment (RD), while it is very uncommon after pars plana vitrectomy (PPV). Although bleb-like lesions were previously reported as small pigment epithelium detachment, OCT has demonstrated that they are small focal retinal detachments.


To define the incidence, duration and clinical associations of persistent localized sub-macular fluid (SMF) after SB for retinal detachment.


Observational retrospective study.


The clinical records of 230 patients following SB for RD werre reviewed. 13 patients (13 eyes) with bleb-like syndrome were detected. In every case, postoperative subfoveal bleb-like lesions had been recorded. Macula was preoperatively detached in 11 of 13 cases. Every patient underwent a complete ophthalmologic examination and spectral-domain optical coherence tomography (SD-OCT, Spectralis, Heidelberg Engineering, Germany) preoperatively and 1, 3, and 6 months postoperatively.


Mean preoperative BCVA was 0.32 ± 0.25. Mean postoperative BCVA at 1, 3 and 6 months respectively was 0.44 ± 0.18, 0.55 ± 0.21 and 0.71 ± 0.19. The follow-up period was 1 year. At the end of the follow-up, SMF was not detectable in 6 eyes, with an average disappearance time of 5.9 ± 1.7 months. 5 eyes retained small amounts of SMF, while in 2 eyes the remaining fluid was extrafoveal. SD-OCT demonstrated a progressive decrease in number and size of subretinal fluid pockets. Inner segment-outer segment junction (IS-OS) was barely identifiable where the neuroretina was detached, while it recovered its normal appearance after fluid reabsorption in all but one cases.


Our data confirm the incidence of bleb-like syndrome after SB procedures and its time course. It could significantly delay functional recovery, though not affecting the final outcome.