title: Pars plana vitrectomy and scleral buckle versus pars plana vitrectomy alone for patients with rhegmatogenous retinal detachment at high risk for proliferative vitreoretinopathy.
abstract: OBJECTIVE
  To compare using pars plana vitrectomy (PPV) combined with a scleral buckle versus primary vitrectomy alone in patients with rhegmatogenous retinal detachment at high risk for postoperative proliferative vitreoretinopathy (PVR).
  
  
  METHODS
  Six hundred and seventy-eight patients were identified from billing data as having rhegmatogenous retinal detachment between April 1, 2010 and August 1, 2012. Patients were considered at high risk for PVR if they presented with retinal detachment in 2 or more quadrants, retinal tears >1 clock hour, preoperative PVR, or vitreous hemorrhage.
  
  
  RESULTS
  Of the 678 patients with rhegmatogenous retinal detachment, 65 were identified as high risk for PVR. Thirty-six patients were treated with simultaneous PPV-scleral buckle and 29 patients were treated with PPV alone, with an overall success rate of 63.1%. The use of PPV-scleral buckle was associated with significantly higher single surgery anatomical success compared with patients treated with PPV alone (odds ratio, 3.24; 95% confidence interval, 1.12-9.17; P = 0.029). Visual acuity at 3 months postprocedure or final follow-up was no different between the treatment groups. Overall, 23.1% of patients developed postoperative PVR with no difference between surgical approaches.
  
  
  CONCLUSIONS
  For patients at high risk for PVR, PPV-scleral buckle was associated with significantly higher rates of anatomical success compared with PPV alone.
authors.affiliation: *Mid Atlantic Retina, Wills Eye Hospital, Philadelphia, Pennsylvania; and †Division of Biostatistics, Jefferson Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania.
authors.forename: Philip
authors.initials: P
authors.lastname: Storey
authors.forename: Rayan
authors.initials: R
authors.lastname: Alshareef
authors.forename: Mohammed
authors.initials: M
authors.lastname: Khuthaila
authors.forename: Nikolas
authors.initials: N
authors.lastname: London
authors.forename: Benjamin
authors.initials: B
authors.lastname: Leiby
authors.forename: Char
authors.initials: C
authors.lastname: DeCroos
authors.forename: Richard
authors.initials: R
authors.lastname: Kaiser
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D058450:Endotamponade; D005260:Female; D006801:Humans; D017075:Laser Coagulation; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012163:Retinal Detachment / Q000503:physiopathology / Q000601:surgery*; D012307:Risk Factors; D012591:Scleral Buckling / Q000379:methods*; D012827:Silicone Oils; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy / Q000379:methods*; D018630:Vitreoretinopathy, Proliferative / Q000209:etiology*; D055815:Young Adult
chemical_list: D012827:Silicone Oils