Functional and anatomic outcome of scleral buckling versus primary vitrectomy in pseudophakic retinal detachment.
OBJECTIVE
To conduct a randomized prospective clinical trial to compare primary vitrectomy without scleral buckling versus conventional scleral buckling surgery in pseudophakic primary retinal detachment (PPRD) in terms of anatomic attachment rate, functional outcome and complications.


METHODS
Fifty consecutive eyes of 50 patients with PPRD were randomized into two groups, with 25 patients in each of group 1 (scleral buckling group) and group 2 (pars plana vitrectomy without buckling group) in a hospital setting and followed up at 1 week, 2 weeks, 6 weeks and 6 months.


RESULTS
A primary reattachment rate of 76% (19 retinas) was obtained in group 1, while a reattachment rate of 84% (21 retinas) was achieved in group 2. The final anatomic reattachment rate was 100% in both groups. The causes of failure in group 1 were proliferative vitreoretinopathy in five eyes and open break/missed break in one eye. The causes of failure in group 2 were missed break/open break in three eyes and proliferative vitreoretinopathy in one eye. Best corrected visual acuity (BCVA) at 2 weeks was better in group 1, while the final BCVA at end of 6 months was two lines better in group 2. The mean change in refractive error was -- 1.38 D in group 1 and -- 0.85 D in group 2.


CONCLUSIONS
Pars plana vitrectomy without buckling provides an effective treatment for PPRD and results in better longterm visual and anatomic outcomes than conventional scleral buckling.
Sharma
Yog Raj
YR
Vitreo-Retina Services, Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
Karunanithi
Sathiyan
S
Azad
Raj Vardhan
RV
Vohra
Rajpal
R
Pal
Nikhil
N
Singh
Deependra Vikram
DV
Chandra
Parijat
P
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007431:Intraoperative Complications; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011446:Prospective Studies; D019591:Pseudophakia / Q000503:physiopathology / Q000601:surgery*; D012030:Refractive Errors / Q000503:physiopathology; D012163:Retinal Detachment / Q000503:physiopathology / Q000601:surgery*; D012591:Scleral Buckling / Q000379:methods*; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology*; D014821:Vitrectomy / Q000379:methods*