[Primary pars plana vitrectomy. Techniques, indications, and results].

Area of Science:

• Ophthalmology
• Retinal Surgery
• Clinical Trials

Context:

• Rhegmatogenous retinal detachment (RRD) management is evolving.
• Primary vitrectomy is increasingly favored for complex RRD.
• Comparative data on surgical approaches for RRD is crucial.

Purpose:

• To compare primary vitrectomy with scleral buckling for RRD.
• To evaluate anatomical and functional outcomes in phakic and pseudophakic patients.
• To determine the optimal surgical strategy for complex RRD.

Summary:

• The SPR study, a randomized multicenter trial, compared primary vitrectomy (with or without scleral buckling) to scleral buckling alone in 681 complex RRD patients.
• In phakic patients, scleral buckling showed an advantage in visual acuity.
• In pseudophakic patients, vitrectomy offered better anatomical results and fewer reoperations, especially when combined with scleral buckling.

Impact:

• Findings guide surgical choices for complex RRD based on lens status.
• Vitrectomy with scleral buckling is recommended for pseudophakic complex RRD.
• Primary vitrectomy may not offer advantages over scleral buckling in phakic complex RRD.