title: Comparison of pars plana vitrectomy with and without scleral buckle for the repair of primary rhegmatogenous retinal detachment.
abstract: OBJECTIVE
  To compare pars plana vitrectomy (PPV) with combined PPV and scleral buckle (SB) for the repair of noncomplex primary rhegmatogenous retinal detachment (RRD).
  
  
  METHODS
  Retrospective, nonrandomized, interventional case series.
  
  
  METHODS
  We reviewed 181 consecutive cases of vitrectomy for primary RRD at 2 major medical centers in Israel. The follow-up was at least 3 months. There were 96 eyes in the PPV group and 85 eyes in the PPV plus SB group. Main outcome measures were single-surgery anatomic success (SSAS) and final visual acuity (VA).
  
  
  RESULTS
  SSAS was achieved in 81.3% and 87.1% in the PPV and PPV plus SB groups, respectively (P=.29). Final anatomic success rate was 98.9% and 98.8%, respectively (P=.61). Final VA was 0.41 (20/51) in the PPV group and 0.53 (20/68) in the PPV plus SB group (P=.13). The final VA was significantly better than the preoperative VA in both groups (P<.0001). In detachments caused by inferior tears, SSAS rates were 80.9% and 81.5% in the PPV and PPV plus SB groups, respectively (P=.74). In phakic eyes, SSAS rates were 92% and 87.5%, respectively, and in pseudophakic eyes, SSAS rates were 77.5% and 86.7%, respectively, in the PPV and PPV plus SB groups (P=.29).
  
  
  CONCLUSIONS
  The reattachment rate and the final VA were similar in both groups. The addition of SB did not improve the results and was associated with slightly lower VA than with PPV alone. Tear location or lens status had no significant effect on success rates. It is likely that in eyes undergoing PPV for primary RRD, addition of a SB is not warranted.
authors.affiliation: The Goldschleger Eye Institute, Sheba Medical Center, Tel Hashomer, Israel. mkinori@hotmail.com
authors.forename: Michael
authors.initials: M
authors.lastname: Kinori
authors.forename: Elad
authors.initials: E
authors.lastname: Moisseiev
authors.forename: Nadav
authors.initials: N
authors.lastname: Shoshany
authors.forename: Ido Didi
authors.initials: ID
authors.lastname: Fabian
authors.forename: Alon
authors.initials: A
authors.lastname: Skaat
authors.forename: Adiel
authors.initials: A
authors.lastname: Barak
authors.forename: Anat
authors.initials: A
authors.lastname: Loewenstein
authors.forename: Joseph
authors.initials: J
authors.lastname: Moisseiev
mesh_terms: D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012163:Retinal Detachment / Q000503:physiopathology / Q000601:surgery*; D012189:Retrospective Studies; D012591:Scleral Buckling; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy