[Primary vitrectomy in rhegmatogenous retinal detachment].

For therapy of uncomplicated rhegmatogenous retinal detachment, a buckling procedure is the standard surgical technique today. In complicated cases, e.g., retinal redetachment after a failed buckling procedure, vitrectomy is established. Meanwhile it is being discussed whether or not certain retinal detachments, e.g., with atypically large tears, should be treated with primary vitrectomy. We studied retrospectively all primary vitrectomies for retinal detachment without proliferative vitreoretinopathy (PVR) that were operated upon during 1992 in Würzburg Eye Hospital (32 patients). In 56% (18 eyes) of the patients a subtotal or total retinal detachment was seen preoperatively; in 47% (15 eyes) the macular region was detached. In 25% (8 eyes) large retinal tears were seen (> 1 h). The other patients showed atypical horseshoe tears partly central to the equator or multiple holes. Seventy-eight percent (25 eyes) of all cases were successfully vitrectomized with one operation and revealed good results using intraocular tamponade (SF-6/air mixture). Seven patients needed further vitrectomy partly using silicone oil as an intraocular tamponade. In cases of rhegmatogenous retinal detachment with atypical tears or non-identified holes, vitrectomy without the buckling procedure is a good alternative, because the rate of successful results is as high as what is achieved with buckling procedure in uncomplicated cases.