Primary Retinal Detachment

Reasons for Primary and Final Failure 129
detachments, primary retinal attachment was obtained in 1,325
eyes or in 91%.After reoperation, attachment resulted in 97.4% and
persisted during a 2-year follow-up (Table 6.3).
Reasons for Primary and Final Failure
Missed Breaks
With minimal segmental buckling, if a break is missed and
drainage not performed, the retina will not become attached at any
time – not at the table, nor spontaneously in the days after surgery.
A missed break was the cause of primary failure in 62 eyes or in
4.2% and, after reoperation, in 12 eyes or in 0.8% (Table 6.3).
Inadequate Buckles
The second most frequent cause of primary failure was an inadequate
buckle, which was present in 51 eyes or in 3.5%. This was
easily corrected by either moving the buckle or enlarging it. After
reoperation, the buckle was no longer a reason for final failure.
Proliferative Vitreoretinopathy
Despite the fact that PVR stage C1–C2 was already present preoperatively
in 43 eyes or in 2.9% of the 1,462 detachments treated, it
was the cause of primary failure in only 20 eyes (1.4%) and, after reoperation,
the cause of final failure in 28 eyes or in 1.9%.
Thus, the presence of PVR did not preclude applying minimal
segmental buckling with sponges or balloons without drainage. By
omitting drainage, a breakdown of the blood–aqueous barrier was
eliminated. By performing cryopexy and buckling with a minimum
of trauma to these vulnerable eyes, a progression of PVR
could be circumvented.