Pars-plana vitrectomy alone vs vitrectomy with scleral buckling for primary rhegmatogenous pseudophakic retinal detachment.
OBJECTIVE
To compare primary pars-plana vitrectomy (PPV) alone vs vitrectomy with an encircling scleral buckling procedure for the treatment of primary rhegmatogenous pseudophakic retinal detachment (PsRD).


METHODS
Prospective, nonrandomized, comparative study.


METHODS
All 71 eyes of 68 consecutive patients with PsRD presented to our service between 1998 and 2002 were offered either vitrectomy alone (group-A) or vitrectomy in combination with encircling scleral buckling procedure (group-B). Preoperative and postoperative patient characteristics were recorded in detail. Main outcome measures were reattachment with a single surgery, visual acuity, and reattachment surgery-related complications.


RESULTS
Retina reattachment with a single surgery was achieved in 97.78% in group A and 92.31% in group B. Visual acuity improved by 3 or more lines in 60% in group A and 69% in group B. Mean postoperative refractive error change (spherical) was -0.05 diopters in group A and -1.43 diopters in group B. Postoperative intraocular pressure on long-term follow-up was elevated in 4.44% (group A) and 34.61% (group B). Average follow-up was 12.45 months (+/-5.23 SD) ranging from 9 to 40 months. We detected additional breaks intraoperatively in 54.9% of cases (both groups).


CONCLUSIONS
Vitrectomy is an effective initial treatment for PsRD, whereas the benefit of an additional encircling buckling procedure is questionable.
Stangos
Alexandros N
AN
Division of Ophthalmology, Department of Clinical Neurosciences, University Hospitals of Geneva, Geneva, Switzerland.
Petropoulos
Ioannis K
IK
Brozou
Catherine G
CG
Kapetanios
Anastasios D
AD
Whatham
Andrew
A
Pournaras
Constantin J
CJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007429:Intraocular Pressure; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D019591:Pseudophakia / Q000601:surgery*; D012163:Retinal Detachment / Q000601:surgery*; D012591:Scleral Buckling / Q000379:methods*; D014792:Visual Acuity; D014821:Vitrectomy / Q000379:methods*