Scleral buckling may have slight advantage over PPV in phakic patients

This meta-analysis found that phakic patients who underwent scleral buckling had slightly better BCVA six months postop than patients managed with pars plana vitrectomy (PPV), which the authors attribute to higher cataract rates in phakic patients managed with PPV.

To the authors’ knowledge this is the first meta-analysis of prospective randomized trials comparing the outcomes of PPV versus scleral buckling in patients with rhegmatogenous retinal detachment (RRD). They evaluated seven randomized controlled trials comparing PPV with scleral buckling for uncomplicated RRD.

Pseudophakic/aphakic patients with RRD had slightly higher secondary reattachment rates when managed with PPV compared with scleral buckling. There were no differences in primary reattachment rates in phakic or pseudophakic/aphakic patients. Additionally, the rates of macular pucker, cystoid macular edema, proliferative vitreoretinopathy and extraocular muscle dysfunction/diplopia were similar between the two groups.