Scleral Buckling and Pars Plana Vitrectomy versus Pars Plana Vitrectomy alone in the Treatment of Rhegmatogenous Retinal Detachment with inferior break

Aim: To compare scleral buckling and pars plane vitrectomy versus pars plane vitrectomy alone in the treatment of inferior RD with inferior retinal breaks. Design: The present study was a randomized controlled trial. Study Settings: It was conducted at the Ophthalmology Unit III, Mayo Hospital Lahore over 1 year from January 2017 to December 2017. Study Procedure: 30 consecutive patients of both genders aged between 20-60 years presenting with rhegmatogenous retinal detachment with inferior break were included after written informed consent. These patients were randomly allocated into 2 treatment groups. Patients in Group-A underwent scleral buckling and pars plane vitrectomy while those in Group-B underwent pars plane vitrectomy alone. Outcome was measured in terms of successful sealing of breaks and visual acuity at 3 and 6 months follow-up. Results: In this study, the mean age of the participants was 42.6 +/- 12.5 years. There were 18 (60.0%) male and 12 (40.0%) female patients with a male to female ratio of 1.5:1. The combined surgical procedure of PPV and SB was associated with significantly better anatomical outcome at 3 months follow-up (83.3% vs. 60.0%; p-value=0.045). However, there was no statistically significant difference after 6 months (86.7% vs. 76.7%; p-value=0.317). Combining PPV with SB was however associated with better functional outcome in terms of visual acuity in such patients. Conclusion: Combining pars plane vitrectomy with scleral buckling was found to good anatomical outcome and was associated with higher visual acuity in patients with rhegmatogenous retinal detachment. Thus it can be advocated that in future practice scleral buckling should also be performed in addition to pars plane vitrectomy to improve the anatomical and functional outcome.