Scleral Buckling Versus Sutureless Parsplana Vitrectomy in the Management of Primary Rhegmatogenous Retinal Detachment

Purpose The aim of the article is to compare scleral buckle (SB) and primary sutureless pars plana vitrectomy (PPV) without SB in rhegmatogenous retinal detachment (RRD) repair. Methods A retrospective study of rhegmatogenous RD surgeries performed between eyes with proliferative vitreoretinopathy (PVR) up to grade B and a minimum of two months postoperative follow-up were included. The primary outcome measure was an improvement in the final best-corrected visual acuity (BCVA) and secondary outcome measures were a final anatomical success, number of resurgeries, and cataract progression. Results A total of 37 eyes in the SB group and 30 eyes in the sutureless PPV group were included. The mean follow-up was 7.5 ± 5 months and 9 ± 4 months in the SB and PPV group, respectively. The improvement in the final BCVA from baseline was four lines in the SB group and five lines in the PPV group (p=0.87). The final anatomical success was 97% in SB and 93% in the PPV group. The number of re-surgeries for attachment of retina were higher in the PPV group, (SB: 8/37 vs PPV: 8/30 p=0.03).The number of resurgeries (16/37 vs. 33/30; p=<0.05), cataract progression (3/37 vs. 10/30; p=0.01), and the mean number of hospital visits (6 vs. 9; p=0.001) were significantly higher in the sutureless PPV group. Conclusions Visual acuity improvement and anatomical success rates were similar between SB and sutureless PPV in RRD repair. The number of operations, cataract progression, and the mean number of hospital visits were higher in the sutureless PPV group.