EDITORIAL Pars Plana Vitrectomy for Primary Retinal Detachment Persistent Anterior Peripheral Retinal Detachment N THE CENTURY SINCE RHEGMATOGENOUS RETI- nal detachment was first repaired by Jules Go- nin, a variety of surgical techniques have been successfully used. From the introduction of the I scleral buckle by Ernst Custodis, MD, in 1949 to the development of the pars plana vitrectomy (PPV) by Robert Machemer, MD, in 1971, the principles of reti- nal reattachment remain consistent: identify the retinal breaks, treat the retinal breaks, and relieve vitreoretinal traction. Contemporary techniques provide unparal- leled opportunities to address a variety of complex reti- nal detachments, but these techniques should not steer vitreoretinal surgeons away from these basic principles. A newly recognized complication of PPV for retinal detachment is the 360 persistent anterior peripheral reti- nal detachment, which has increasingly emerged after the current emphasis on primary vitrectomy for retinal de- tachment repair. This complication is identified after reti- nal detachment surgery using PPV without scleral buck- ling and with barrier laser demarcation at the equator, and it is due to untreated anterior retinal breaks (see rep- resentative patients in Figures 1, 2, and 3). These pa- tients warrant discussion because of early and
JAMA Ophthalmology – American Medical Association
Published: May 1, 2013
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