Pars-plana vitrectomy alone vs vitrectomy with scleral buckling for primary rhegmatogenous pseudophakic retinal detachment

PURPOSE: To compare primary pars-plana vitrectomy (PPV) alone vs vitrectomy with an encircling scleral buckling procedure for the treatment of primary rhegmatogenous pseudophakic retinal detachment (PsRD). DESIGN: Prospective, nonrandomized, comparative study. METHODS: All 71 eyes of 68 consecutive patients with PsRD presented to our service between 1998 and 2002 were offered either vitrectomy alone (group-A) or vitrectomy in combination with encircling scleral buckling procedure (group-B). Preoperative and postoperative patient characteristics were recorded in detail. Main outcome measures were reattachment with a single surgery, visual acuity, and reattachment surgery-related complications. RESULTS: Retina reattachment with a single surgery was achieved in 97.78% in group A and 92.31% in group B. Visual acuity improved by 3 or more lines in 60% in group A and 69% in group B. Mean postoperative refractive error change (spherical) was -0.05 diopters in group A and -1.43 diopters in group B. Postoperative intraocular pressure on long-term follow-up was elevated in 4.44% (group A) and 34.61% (group B). Average follow-up was 12.45 months (+/-5.23 SD) ranging from 9 to 40 months. We detected additional breaks intraoperatively in 54.9% of cases (both groups). CONCLUSIONS: Vitrectomy is an effective initial treatment for PsRD, whereas the benefit of an additional encircling buckling procedure is questionable.