Prospective study comparing the effectiveness of scleral buckling to vitreous surgery for rhegmatogenous retinal detachment

Purpose: To compare the effectiveness of scleral buckling to vitrectomy for the treatment of rhegmatogenous retinal detachment (RRD) due to equatorial retinal tears. Methods: Forty-six patients (46 eyes) >= 50 years of age with RRD due to equatorial retinal tears were studied. One group of 23 patients was selected by the randomized envelope method to be treated by scleral buckling and a second group of 23 to be treated by vitrectomy. The rate of retinal reattachment, the visual acuity, optical coherence tomography findings, and postoperative complications were determined. In addition, a questionnaire was filled out by the patients on their subjective assessment of the surgery and recovery. Results: The rate of retinal reattachment was identical in the two groups. The postoperative visual acuity, the number of patients with visual acuity >= 0.8 and the mean visual acuity were significantly better in the vitrectomy group (chi-squared and Mann-Whitney U tests, P < 0.05) within 12 months after surgery. At 24 and 36 months, the differences in the visual acuity were not significant. The answers to the questionnaire given by the patients in the vitrectomy group suggested that their surgical experiences and visual recovery were better than those of patients in the scleral buckling group. Conclusion: In patients 50 years of age, vitrectomy was more effective than scleral buckling for obtaining good visual acuity in the short term.