JP Berrod, I Hubert, K Naoun, JC Badet Nancy, France


To report the anatomic and visual results of primary pars plana vitrectomy (PPV) without scleral buckling to repair primary rhegmatogenous retinal detachment (RD).


Nonrandomized prospective comparative clinical trial including 226 consecutive eyes with 6 months follow-up. Patients underwent PPV, retinal reattachment with fluid-gas exchange, and transcleral cryopexy of the breaks and peripheral retina under control of wide angle viewing system.


Preoperatively: 125 eyes were phakic and 101 eyes pseudophakic. Among the phakic patients, maculae were detached in 101 eyes (81%), mean extend of RD was 2,7 quadrants and PVR was superior to grade A in 70 eyes (56%). Among the pseudophakic patients, maculae were detached in 72 eyes (71%), mean extend of RD was 2,6 quadrants and PVR was superior to grade A in 40 eyes (40%). Postoperatively: retinas were reattached with one operation in 120 (96%) of the phakic eyes and in 89 (88%) of the pseudophakic eyes. All retinas were reattached with subsequent surgery. The median preoperative visual acuity rose postoperatively from 1,1/10è to 3,8/10è in phakic eyes and to 5/10è in pseudophakic eyes. Refractive error measurement obtained was –2 diopters in phakic patients related to nuclear sclerosis present in 50 eyes (82%) and –0,3 diopter in pseudophakic.


Primary PPV with fluid-gas exchange and cryopexy is a very effective method to repair retinal detachment whatever the status of the lens but carries a high risk of nuclear sclerosis in phakic eyes.