title: Primary vitrectomy for rhegmatogenous retinal detachment: an analysis of failure.
abstract: OBJECTIVE
  To find the cause of failure in primary vitrectomy for rhegmatogenous retinal detachment.
  
  
  METHODS
  Retrospective review of 171 consecutive cases of RRD treated by primary pars plana vitrectomy (PPV) from a tertiary referral centre to identify the 25 cases in which surgery had failed. Detachments with giant or macula breaks at initial presentation, with proliferative diabetic retinopathy or with PVR greater than grade B were excluded.
  
  
  RESULTS
  The failure rate after the first operation was 14.6% and the commonest cause of failure was missed retinal breaks, accounting for 64.3% of failures.
  
  
  CONCLUSIONS
  Missed retinal breaks are the commonest cause of failure of primary PPV for RRD although proliferative vitreoretinopathy may contribute to surgical failure. This re-emphasises the importance of assiduous peroperative retinal examination.
authors.affiliation: Department of Ophthalmology, St. Thomas' Hospital, London, UK.
authors.forename: E C
authors.initials: EC
authors.lastname: Richardson
authors.forename: S
authors.initials: S
authors.lastname: Verma
authors.forename: W T
authors.initials: WT
authors.lastname: Green
authors.forename: H
authors.initials: H
authors.lastname: Woon
authors.forename: A H
authors.initials: AH
authors.lastname: Chignell
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012086:Reoperation; D012163:Retinal Detachment / Q000175:diagnosis / Q000601:surgery*; D012167:Retinal Perforations / Q000175:diagnosis; D012189:Retrospective Studies; D013997:Time Factors; D017211:Treatment Failure; D014821:Vitrectomy; D018630:Vitreoretinopathy, Proliferative / Q000175:diagnosis