Pars Plana Vitrectomy versus Combined Scleral Buckling—Pars Plana Vitrectomy for Phakic Rhegmatogenous Retinal Detachment with Inferior Breaks

Aims: To compare the results of pars plana vitrectomy (PPV) and combined scleral buckling—PPV (SB/PPV) in phakic rhegmatogenous retinal detachments with inferior breaks. Methods: Randomized, prospective, clinical controlled trial of forty consecutive phakic eyes with primary rhegmatogenous retinal detachment, associated with inferior breaks and not complicated by proliferative vitreoretinopathy ≥grade C, to either PPV (group 1) or combined SB/PPV (group 2). Results: At 6 months follow up the primary reattachment rate was 100% (20/20 cases) in group 2 and 70% (14/20 cases) in the group 1, the difference being statistically significant (p = 0.027). The best corrected visual acuity improved significantly from a preoperative mean of 1.65 ± 1.13 (Range: 0.6 to 3) to a mean of 0.45 ± 0.11 (Range: 0.3 to 0.6) in the group 2 and in the group 1 improved from a preoperative mean of 2.34 ± 0.92 (Range: 0.48 to 3) to a mean of 0.668 ± 0.20 (Range: 0.48 to 1), the difference between the two groups being statistically significant (p = 0.001). Conclusion: Anatomical and functional success rates are significantly better with the use of a scleral explant during PPV for uncomplicated forms of phakic rhegmatogenous retinal detachments with inferior breaks.