Stefanie Pape (Bremen, Germany)

With advances in vitrectomy techniques in recent years there has been a trend away from buckling and towards primary vitreous surgery with combined lens exchange for primary uncomplicated retinal detachments in presbyopic patients in which the preservation of the natural lens is of secondary importance. A number of reasons seem to be responsible for this development:
• learning vitrectomy techniques seems to have an easier learning curve than buckling surgery
• early cataract is dealt with at the same time saving the patient additional surgery at a later stage
• vitreous opacities are removed making for clearer postoperative vision
Ametropia can be dealt with at the same time, offering the patient the option of choosing réfractive
In our institution the proportion of eyes undergoing primary vitrectomy for uncomplicated retinal detachments in patients 55 years or older has risen from 15% in the years 1995 to 2000 to about 67% in recent years.
This presentation will compare the outcomes in earlier times with the current approach, investigate the pros and cons of primary vitrectomy and discuss the implications for the future strategy in the management of retinal detachment.