title: SCLERAL BUCKLING VERSUS VITRECTOMY IN THE MANAGEMENT OF MACULA-OFF PRIMARY RHEGMATOGENOUS RETINAL DETACHMENT: A COMPARISON OF VISUAL OUTCOMES.
abstract: OBJECTIVE
  To compare visual outcomes between pars plana vitrectomy (PPV) with or without scleral buckling (SB) and SB alone in the management of uncomplicated macula-off primary rhegmatogenous retinal detachment.
  
  
  METHODS
  Case-control study of 723 patients with uncomplicated macula-off primary rhegmatogenous retinal detachment seen at the Singapore National Eye Centre from 2005 to 2011. The primary outcome measure was the proportion of eyes achieving functional success, defined as logMAR best-corrected visual acuity of ≤0.3 logMAR at 6 months postoperatively. Multivariable logistic regression analysis was performed adjusting for the following preoperative covariates: age, gender, race, lens status, number of tears found, presence of proliferative vitreoretinopathy, operative procedure, logMAR best-corrected visual acuity, and duration of symptoms.
  
  
  RESULTS
  Three hundred and eight eyes underwent SB alone, and 415 eyes underwent PPV ± SB. In the SB group, 133 eyes (43.2%) achieved functional success compared with 116 eyes (28.0%) in the PPV ± SB group. This difference was statistically significant on both univariate (P < 0.001) and multivariable analyses (OR: 1.51, 95% CI: 1.03-2.21, P = 0.03).
  
  
  CONCLUSIONS
  Scleral buckling alone may achieve visual outcomes that are at least comparable with PPV ± SB in the management of macula-off primary rhegmatogenous retinal detachment.
authors.affiliation: *Singapore National Eye Centre, Vitreoretinal Service, Singapore, Singapore; and †Singapore Eye Research Institute, Singapore, Singapore.
authors.forename: Chee Wai
authors.initials: CW
authors.lastname: Wong
authors.forename: Ian Yew San
authors.initials: IY
authors.lastname: Yeo
authors.forename: Boon Kwang
authors.initials: BK
authors.lastname: Loh
authors.forename: Edmund Yick Mun
authors.initials: EY
authors.lastname: Wong
authors.forename: Doric Wen Kuan
authors.initials: DW
authors.lastname: Wong
authors.forename: Sze Guan
authors.initials: SG
authors.lastname: Ong
authors.forename: Chong Lye
authors.initials: CL
authors.lastname: Ang
authors.forename: Shu Yen
authors.initials: SY
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D016015:Logistic Models; D008266:Macula Lutea / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012163:Retinal Detachment / Q000503:physiopathology / Q000601:surgery*; D012189:Retrospective Studies; D012591:Scleral Buckling / Q000379:methods*; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy / Q000379:methods*; D018630:Vitreoretinopathy, Proliferative / Q000601:surgery