Aims: To compare the success rates of vitrectomy and gas with vitrectomy, gas, and buckle in the treatment of inferior break retinal detachments. Methods: A r etrospective case note review of 86 patients who presented with inferior break r etinal detachments was carried out. An inferior break was defined as a horseshoe tear present between 4 and 8 o’clock. Patients were analysed in two groups; gr oup A consisted of 41 patients who underwent a vitrectomy and gas, group B consi sted of 45 patients who underwent a vitrectomy, gas, and scleral buckle. The fea tures of the retinal detachment, peroperative and postoperative complications, a nd outcomes of treatment were recorded for each patient. Results: The primary an atomical success rate at 3 months was 89%in group A versus 73%in group B (P= 0 .11). There was no statistical difference in the complication rate between the t wo groups (P=0.819). The most common cause of treatment failure was proliferativ e vitreoretinopathy, 20%(n=9) in group B compared with 5%(n=2) in group A and this reached statistical significance (P=0.0159). There was a higher rate o f epiretinal membrane development in group B (P=0.000 4). The final attachment r ate was not statistically different between the two groups, 95%(39) in group A and 93%(42) in group B (P=1.0). Conclusion: Vitrectomy and gas without the appl ication of a scleral buckle may be used to safely treat inferior break retinal d etachments. It may be used as an alternative to vitrectomy, gas, and buckle whic h has an increased risk of choroidal haemorrhage, requires a longer operating ti me, and has all the associated complications of a scleral buckle.
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