Purpose: To conduct a randomized prospective clinical trial to compare primary vitrectomy without scleral buckling versus conventional scleral buckling surger y in pseudophakic primary retinal detachment (PPRD) in terms of anatomic attachm ent rate, functional outcome and complications. Methods: Fifty consecutive eyes of 50 patients with PPRD were randomized into two groups, with 25 patients in ea ch of group 1 (scleral buckling group) and group 2 (pars plana vitrectomy withou t buckling group) in a hospital setting and followed up at 1 week, 2 weeks, 6 we eks and 6 months. Results: A primary reattachment rate of 76%(19 retinas) was o btained in group 1, while a reattachment rate of 84%(21 retinas) was achieved i n group 2. The final anatomic reattachment rate was 100%in both groups. The cau ses of failure in group 1were proliferative vitreoretinopathy in five eyes and o pen break/ missed break in one eye. The causes of failure in group 2 were missed break/op en break in three eyes and proliferative vitreoretinopathy in one eye. Best corr ected visual acuity (BCVA) at 2 weeks was better in group 1, while the final BCV A at end of 6 months was two lines better in group 2. The mean change in refract ive error was-1.38 D in group 1 and-0.85 D in group 2. Conclusions: Pars plana vitrectomywithout buckling provides an effective treatment for PPRD and results in better longterm visual and anatomic outcomes than conventional scleral buckl ing.
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