Primary buckle surgery for retinal detachments with undetected break

Background and objective: The treatment of retinal detachment (RD) with uns een break has not been clearly defined, The aim of this study was to evalua te the results of scleral buckle surgery as the primary treatment for RD wi th unseen break without initial proliferative vitreo-retinopathy. Material and methods: This study included charts of 100 consecutive patient s: 63 pseudophakic cases, 37 phakic cases, undergoing a scleral buckle, 51 of which were circumferential and 49 localized. Results: The primary reattachment rate was 75%. There was no statistical di fference according to the status of the lens and the extent of the circumfe rential versus localized buckle. The reattachment rate at 6 months was 92% with a mean of 1.2 operations per patient. Conclusion: An unseen break is an unfavorable factor for the anatomic succe ss of scleral buckle, whether it be circumferential or localized. The bette r results of vitrectomy in pilot studies justify a controlled randomized st udy comparing it to conventional buckle surgery for RD with unseen break, p articulary for phakic patients.