Ferenc Kuhn (Hungary / USA), Zora Ignjatovic (Belgrade, Serbia)

Advantages:

Even though the retinal break is thought to be the cause of the retinal detachment, the break is secondary to – typically dynamic – vitreoretinal traction. Vitrectomy is the rational approach to treatment by addressing the source, rather than the consequence, as scleral buckling does, however effectively. In addition, other pathologies such as media opacity or proliferative vitreoretinopathy can also be properly addressed via vitreous surgery.

Methods:

Complete removal of the vitreous, including posteriorly (including surgical detachment if necessary), anteriorly (vitreous base) and behind the lens. This is followed by laser retinopexy and (short-term) gas tamponade.

Effectiveness / Safety:

This method has proven extremely effective, with no primary failure for over three years, regardless of break location (inferior breaks), number, or size, as well as of lens status.

Take home message:

Vitrectomy for rhegmatogenous retinal detachment: just do it!