Scleral Surgery or Vitrectomy in Primary Rhegmatogenous Retinal Detachment

Introduction: Introduction Several studies evaluated and compared the surgical success of the primary rhegmatogenous retinal detachment (PRRD) using scleral buckling (SB) procedure or pars plana vitrectomy (PPV) in randomized design in the attempt of define the superiority of one of the two techniques in absolute. In our study we consider the two techniques complementary, choosing the surgical procedure according to preoperative evaluation, and evaluated the rate of use of SB or PPV and the surgical results. Methods or Study Design: Methods We retrospectively examined the clinical charts of patients underwent surgery for PRRD between the 2007 and 2012. We excluded patients with proliferative diabetic retinopathy, uveitis, and trauma. We collected the following data: sex, age, eye, surgical technique, duration of surgery, best corrected visual acuity preoperative, post op. and after 6 months, macular involvement, prior cataract surgery. We calculated the rate of SB (scleral operation rate SOR), the single operation success rate (SOSR) for both SB and PPV, and we performed a multivariate logistic regression to evaluate the influence of covariates on SOSR. With a multivariate proportional odds regression we analyzed the factors influencing the final BCVA. We considered statistically significative a p > Results: Results We included 161 eyes, 133 underwent to SB procedure (SOR 82.6%), with a SOSR of 88.7%, and a SOSR for PPV 89.3% with a non significative difference. In the multivariate analysis we report a significative influence on SOSR of the age and male sex, the surgical choose did not influenced the anatomical result, nor the pseudophachic status. The mean BCVA incremented postoperatively in all groups without any statistically significant difference. The multivariate analysis of BCVA after 6 months confirmed this finding. Although initial BCVA of the PPV group was significantly lower. Conclusions: Conclusions This study highlight that the SB procedure is suitable to resolve the majority of the PRRD, choosing this technique after a thorough funds examination. The two techniques are to be considered complementary, preferring PPV in giant or posterior retinal tears, when the BCVA is lower. Then our data show there is not any difference in the surgical and functional outcomes. The rate of surgical success SOSR we report hereby are comparable and higher than the rates reported in the randomized trials, then we support an appropriate preoperative choose.