Comparison of Pars Plana Vitrectomy With and Without Scleral Buckle for the Repair of Primary Rhegmaitogenous Retinal Detachment

PURPOSE: To compare pars plana vitrectomy (PPV) with combined PPV and scleral buckle (SB) for the repair of noncomplex primary rhegmatogenous retinal detachment (RRD). DESIGN: Retrospective, nonrandomized, interventional case series. METHODS: We reviewed 181 consecutive cases of vitrectomy for primary RRD at 2 major medical centers in Israel. The follow-up was at least 3 months. There were 96 eyes in the PPV group and 85 eyes in the PPV plus SB group. Main outcome measures were single-surgery anatomic success (SSAS) and final visual acuity (VA). RESULTS: SSAS was achieved in 81.3% and 87.1% in the PPV and PPV plus SB groups, respectively (P = .29). Final anatomic success rate was 98.9% and 98.8%, respectively (P = .61). Final VA was 0.41(20/51) in the PPV group and 0.53 (20/68) in the PPV plus SB group (P = .13). The final VA was significantly better than the preoperative VA in both groups (P < .0001). In detachments caused by inferior tears, SSAS rates were 80.9% and 81.5% in the PPV and PPV plus SB groups, respectively (P = .74). In phakic eyes, SSAS rates were 92% and 87.5%, respectively, and in pseudophakic eyes, SSAS rates were 77.5% and 86.7%, respectively, in the PPV and PPV plus SB groups (P = .29). CONCLUSIONS: The reattachment rate and the final VA were similar in both groups. The addition of SB did not improve the results and was associated with slightly lower VA than with PPV alone. Tear location or lens status had no significant effect on success rates. It is likely that in eyes undergoing PPV for primary RRD, addition of a SB is not warranted. (Am J Ophthalmol 2011;152:291-297. (C) 2011 by Elsevier Inc. All rights reserved.)