title: Strategy for the management of uncomplicated retinal detachments: the European vitreo-retinal society retinal detachment study report 1.
abstract: OBJECTIVE
  To study success and failure in the treatment of uncomplicated rhegmatogenous retinal detachments (RRDs).
  
  
  METHODS
  Nonrandomized, multicenter retrospective study.
  
  
  METHODS
  One hundred seventy-six surgeons from 48 countries spanning 5 continents provided information on the primary procedures for 7678 cases of RRDs including 4179 patients with uncomplicated RRDs.
  
  
  METHODS
  Reported data included specific clinical findings, the method of repair, and the outcome after intervention.
  
  
  METHODS
  Final failure of retinal detachment repair (level 1 failure rate), remaining silicone oil at the study's conclusion (level 2 failure rate), and need for additional procedures to repair the detachment (level 3 failure rate).
  
  
  RESULTS
  Four thousand one hundred seventy-nine uncomplicated cases of RRD were included. Combining phakic, pseudophakic, and aphakic groups, those treated with scleral buckle alone (n = 1341) had a significantly lower final failure rate than those treated with vitrectomy, with or without a supplemental buckle (n = 2723; P = 0.04). In phakic patients, final failure rate was lower in the scleral buckle group compared with those who had vitrectomy, with or without a supplemental buckle (P = 0.028). In pseudophakic patients, the failure rate of the initial procedure was lower in the vitrectomy group compared with the scleral buckle group (P = 3×10(-8)). There was no statistically significant difference in failure rate between segmental (n = 721) and encircling (n = 351) buckles (P = 0.5). Those who underwent vitrectomy with a supplemental scleral buckle (n = 488) had an increased failure rate compared with those who underwent vitrectomy alone (n = 2235; P = 0.048). Pneumatic retinopexy was found to be comparable with scleral buckle when a retinal hole was present (P = 0.65), but not in cases with a flap tear (P = 0.034).
  
  
  CONCLUSIONS
  In the treatment of uncomplicated phakic retinal detachments, repair using scleral buckle may be a good option. There was no significant difference between segmental versus 360-degree buckle. For pseudophakic uncomplicated retinal detachments, the surgeon should balance the risks and benefits of vitrectomy versus scleral buckle and keep in mind that the single-surgery reattachment rate may be higher with vitrectomy. However, if a vitrectomy is to be performed, these data suggest that a supplemental buckle is not helpful.
  
  
  BACKGROUND
  The author(s) have no proprietary or commercial interest in any materials discussed in this article.
authors.affiliation: Department of Ophthalmology & Visual Science, Yale University School of Medicine, New Haven, Connecticut, USA. ron.adelman@yale.edu
authors.forename: Ron A
authors.initials: RA
authors.lastname: Adelman
authors.forename: Aaron J
authors.initials: AJ
authors.lastname: Parnes
authors.forename: Didier
authors.initials: D
authors.lastname: Ducournau
mesh_terms: D058450:Endotamponade; D005060:Europe; D019538:Health Care Surveys; D006801:Humans; D009885:Ophthalmology; D012163:Retinal Detachment / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D012189:Retrospective Studies; D012591:Scleral Buckling; D012955:Societies, Medical; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy; D057586:Vitreoretinal Surgery / Q000379:methods