Primary Retinal Detachment: Pars Plana Vitrectomy

This chapter provides an in-depth exploration of the surgical principles and technique of pars plana vitrectomy for the treatment of primary rhegmatogenous retinal detachment (RRD). The main steps of vitrectomy for RRD include relieving vitreoretinal traction, finding retinal breaks, drainage of subretinal fluid, sealing the breaks (retinopexy), and tamponade use for retinal support. The authors discuss various surgical strategies, complications, and special considerations for specific types of RRD cases, including those associated with high myopia, choroidal detachment, and cases where the retinal tear cannot be found. The chapter also highlights the significance of postoperative posturing, retinal displacement, and factors contributing to primary RRD failure. The authors also discuss other complications of vitrectomy surgery including iatrogenic retinal tears, macular holes, and retinal folds.