Long-Term Real-Life Outcomes of Vitrectomy and Air Tamponade for Primary Retinal Detachment Repair

Purpose To report outcomes of pars plana vitrectomy (PPV) with air tamponade for primary rhegmatogenous retinal detachment (RRD) and investigate the impact of vitreous cortex remnants (VCR) on surgical outcomes. Methods A retrospective review of 900 patients treated for uncomplicated primary RRD between 2007 and 2020. Exclusion criteria included axial length > 26 mm, prior retinal surgery, giant retinal tear, PVR grade > B, and inadequate follow-up. Primary outcomes were retinal reattachment rate and best-corrected visual acuity (BCVA). Results Of 900 patients, 397 met inclusion criteria. Primary reattachment rate was 88.4%, with significant BCVA improvement. Forty-six eyes experienced RRD recurrence. Complications included cataracts (38.8%), IOP rise (11.4%), and macular edema (8.3%). Better final BCVA was associated with preoperative macular non-involvement and absence of reinterventions. No significant association was found between RRD recurrence and various factors, including VCR removal. Conclusion Air tamponade is a safe and effective option for primary RRD treatment. It has no negative effect on the environment and creates less discomfort for patients. VCR removal did not significantly reduce RRD recurrence in the overall number of cases. Further research will help determine the role of VCR in RD recurrence and define in which cases their removal might be beneficial.