Primary Retinal Detachment

Chapter 8
Systematic Review of Efficacy and Safety of Surgery
for Primary Retinal Detachment
Harvey Lincoff, Anne Lincoff, Marcin Stopa
Introduction
There is currently a debate about whether the buckle operation
should be replaced by two intraocular procedures, pneumatic
retinopexy and vitrectomy, for the repair of retinal detachment. To
obtain comparative results, we examined case series in the literature
from 1972 to 2003 that enrolled patients with primary retinal
detachment who were treated by either pneumatic retinopexy,
vitrectomy, or segmental buckling.
Materials and Methods
The literature was reviewed from 1972 to 2003 for reports about repair
of primary retinal detachment. The database (Medline) was
searched with keywords: primary retinal detachment and pneumatic
retinopexy, vitrectomy, and buckle. We found a total of 329
trials (Tables 8.1–8.3). Inclusion criteria were that the detachments
were uncomplicated; the extension of the detachments, number of
breaks, and the age of the detachments were not a factor. Studies
were excluded if proliferative vitreoretinopathy (PVR) was greater
than a C1. There were 25 studies enrolling 1,465 patients treated
with primary vitrectomy [1–25], 29 studies enrolling 1,919 patients
for pneumatic retinopexy [26–54], and 10 studies enrolling 1,854
patients treated with segmental buckles [55–62]. Unsuccessful primary
attachment and the presence of PVR postoperatively were