Abstract
Purpose: To analyze anatomic and visual outcomes of young adults with uncomplicated primary rhegmatogenous retinal detachment (RRD) treated with scleral buckle, pars plana vitrectomy (PPV), or combined PPV and scleral buckle. Methods: Patients included in the Primary Retinal Detachment Outcomes study with a minimum of 6 months follow-up were evaluated in this multicenter interventional cohort study,. Patients with complex RRDs were excluded. Primary outcomes were single surgery anatomic success and final visual acuity (VA). Results: Scleral buckle was performed in 91 eyes (55%), PPV in 32 (19%), and combined PPV and scleral buckle in 42 (25%). Single surgery anatomic success rates were 79.3% for PPV alone, 83.7% for primary scleral buckle, and 92.7% for combined PPV and scleral buckle (analysis of variance, P = .25). When adjusting for potential risk factors, eyes that had PPV alone were more likely to redetach compared with those that had combined PPV and scleral buckle (hazard ratio [HR], 7.24, 95% CI, 1.25-42.1; P = .03), while rates of redetachment were similar in eyes that had scleral buckle alone and combined PPV and scleral buckle (HR, 3.24, 95% CI, 0.63-16.63; P = .16). However, eyes that had combined PPV and scleral buckle were less likely to result in good vision compared with eyes that had scleral buckle alone (odds ratio [OR], 0.26, 95% CI, 0.07-0.94; P = .04). Similarly, eyes that had PPV alone were less likely to obtain good vision compared with eyes that only had scleral buckle (OR, 0.20, 95% CI, 0.05-0.81; P = .02). Conclusions: For young adults in this study, the best visual outcomes resulted from scleral buckle, and a higher single surgery success rate was found with combined PPV and scleral buckle.