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Pars plana vitrectomy (PPV), scleral buckle (SB), and pneumatic retinopexy (PR) are all safe and effective treatments for retinal detachment. However, despite numerous clinical trials, there is no compelling evidence that one method is superior to another in all cases. The best intervention for a retinal detachment will depend on the surgeon’s expertise and experience, and the patient’s individual circumstances, and should be chosen following a discussion of the indications, risks, and benefits of the different operations.
Vitreoretinal surgeons in training should strive to acquire experience and skills in all three techniques of PPV, SB and PR, and to learn to apply them judiciously in various clinical settings.
Vitreoretinal surgeons should audit continuously the results of their retinal detachment surgery, and include it as a part of their annual appraisal. Most modern series give a primary anatomic success of around 85% (excluding paediatric retinal detachments), which can be used as a standard against which individual results can be compared. BEAVRS Retinal Detachment dataset is an excellent benchmarking and revalidation tool, designed for this purpose. At the same time, there should be increased consideration given to functional outcomes, with flexibility to adopt new techniques as more evidence comes to light.