title: 23-Gauge Pars Plana Vitrectomy Versus Scleral Buckling Versus Combined Pars Plana Vitrectomy-Scleral Buckling for Medium-Complexity Retinal Detachment Repair.
abstract: OBJECTIVE
  To compare the anatomic and visual outcomes of 23-gauge pars plana vitrectomy (PPV), scleral buckling (SB), and combined 23-gauge PPV/SB in the treatment of primary medium-complexity rhegmatogenous retinal detachment (RRD).
  
  
  METHODS
  A retrospective, consecutive case series.
  
  
  METHODS
  A consecutive chart review of patients with medium-complexity RRD treated with PPV, SB, and combined PPV/SB was conducted. The primary outcome measure was retinal reattachment at 6 months' follow-up. The secondary outcome measure was Snellen best-corrected visual acuity (BCVA) of 20/40 or better at 6 months' follow-up.
  
  
  RESULTS
  Five hundred sixty-five cases met inclusion criteria. The overall primary anatomic success rate was 83.6% (95% confidence interval, 80.3%-86.5%). Logistic regression analysis did not demonstrate a significant difference between the 3 techniques in terms of likelihood of anatomic success or likelihood of achieving a Snellen BCVA of 20/40 or better. Patients with multiple breaks in 2 or more quadrants or inferior breaks were more likely to undergo SB/PPV, whereas patients with phakic lens status with breaks confined to 1 quadrant were more likely to undergo SB. Patients with macula-off detachments and those with postoperative proliferative vitreoretinopathy were less likely to achieve a Snellen BCVA of 20/40 or better.
  
  
  CONCLUSIONS
  Although there was not a statistically significant difference in the anatomic and visual outcomes between the repair techniques analyzed, SB/PPV was performed on the more complicated spectrum of medium-complexity RRDs with the overall highest anatomic success rate and therefore may be the most effective repair technique for this patient population.
authors.affiliation: From the *Sydney Eye Hospital and †Save Sight Institute, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Ryan
authors.initials: R
authors.lastname: Rush
authors.forename: Matthew P
authors.initials: MP
authors.lastname: Simunovic
authors.forename: Saumil
authors.initials: S
authors.lastname: Sheth
authors.forename: Andrew
authors.initials: A
authors.lastname: Chang
authors.forename: Alex P
authors.initials: AP
authors.lastname: Hunyor