title: Functional and anatomic outcome of scleral buckling versus primary vitrectomy in pseudophakic retinal detachment.
abstract: 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.
authors.affiliation: Vitreo-Retina Services, Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Yog Raj
authors.initials: YR
authors.lastname: Sharma
authors.forename: Sathiyan
authors.initials: S
authors.lastname: Karunanithi
authors.forename: Raj Vardhan
authors.initials: RV
authors.lastname: Azad
authors.forename: Rajpal
authors.initials: R
authors.lastname: Vohra
authors.forename: Nikhil
authors.initials: N
authors.lastname: Pal
authors.forename: Deependra Vikram
authors.initials: DV
authors.lastname: Singh
authors.forename: Parijat
authors.initials: P
authors.lastname: Chandra
mesh_terms: 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*