title: Primary Repair of Moderate Severity Rhegmatogenous Retinal Detachment: A Critical Decision-Making Algorithm.
abstract: We reviewed all the available data regarding the current management of non-complex rhegmatogenous retinal detachment and aimed to propose a new decision-making algorithm aimed to improve the single surgery success rate for mid-severity rhegmatogenous retinal detachment. An online review of the Pubmed database was performed. We searched for all available manuscripts about the anatomical and functional outcomes after the surgical management, by either scleral buckle or primary pars plana vitrectomy, of retinal detachment. The search was limited to articles published from January 1995 to December 2015. All articles obtained from the search were carefully screened and their references were manually reviewed for additional relevant data. Our search specifically focused on preoperative clinical data that were associated with the surgical outcomes. After categorizing the available data according to their level of evidence, with randomized-controlled clinical trials as the highest possible level of evidence, followed by retrospective studies, and retrospective case series as the lowest level of evidence, we proceeded to design a logical decision-making algorithm, enhanced by our experiences as retinal surgeons. A total of 7 randomized-controlled clinical trials, 19 retrospective studies, and 9 case series were considered. Additional articles were also included in order to support the observations further. Rhegmatogenous retinal detachment is a potentially blinding disorder. Its surgical management seems to depend more on a surgeon´s preference than solid scientific data or is based on a good clinical history and examination. The algorithms proposed herein strive to offer a more rational approach to improve both anatomical and functional outcomes after the first surgery.
authors.affiliation: Retina Department. Asociación para Evitar la Ceguera en México IAP, México City DF, Mexico.
authors.forename: Raul
authors.initials: R
authors.lastname: Velez-Montoya
authors.affiliation: Retina Department. Asociación para Evitar la Ceguera en México IAP, México City DF, Mexico.
authors.forename: Paola
authors.initials: P
authors.lastname: Jacobo-Oceguera
authors.affiliation: Retina Department. Asociación para Evitar la Ceguera en México IAP, México City DF, Mexico.
authors.forename: Javier
authors.initials: J
authors.lastname: Flores-Preciado
authors.affiliation: Retina Department. Asociación para Evitar la Ceguera en México IAP, México City DF, Mexico.
authors.forename: Jose
authors.initials: J
authors.lastname: Dalma-Weiszhausz
authors.affiliation: Retina Department. Asociación para Evitar la Ceguera en México IAP, México City DF, Mexico.
authors.forename: Jose
authors.initials: J
authors.lastname: Guerrero-Naranjo
authors.affiliation: Retina Department. Asociación para Evitar la Ceguera en México IAP, México City DF, Mexico.
authors.forename: Guillermo
authors.initials: G
authors.lastname: Salcedo-Villanueva
authors.affiliation: Retina Department. Asociación para Evitar la Ceguera en México IAP, México City DF, Mexico.
authors.forename: Gerardo
authors.initials: G
authors.lastname: Garcia-Aguirre
authors.affiliation: Retina Department. Asociación para Evitar la Ceguera en México IAP, México City DF, Mexico.
authors.forename: Jans
authors.initials: J
authors.lastname: Fromow-Guerra
authors.affiliation: Retina Department. Asociación para Evitar la Ceguera en México IAP, México City DF, Mexico.
authors.forename: Virgilio
authors.initials: V
authors.lastname: Morales-Canton
keywords: Algorithm; Primary Pars Plana Vitrectomy; Primary Repair; Rhegmatogenous Retinal Detachment; Scleral Buckle