title: Pars-plana vitrectomy alone vs vitrectomy with scleral buckling for primary rhegmatogenous pseudophakic retinal detachment.
abstract: 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.
authors.affiliation: Division of Ophthalmology, Department of Clinical Neurosciences, University Hospitals of Geneva, Geneva, Switzerland.
authors.forename: Alexandros N
authors.initials: AN
authors.lastname: Stangos
authors.forename: Ioannis K
authors.initials: IK
authors.lastname: Petropoulos
authors.forename: Catherine G
authors.initials: CG
authors.lastname: Brozou
authors.forename: Anastasios D
authors.initials: AD
authors.lastname: Kapetanios
authors.forename: Andrew
authors.initials: A
authors.lastname: Whatham
authors.forename: Constantin J
authors.initials: CJ
authors.lastname: Pournaras
mesh_terms: 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*