The learning curve for primary vitrectomy without scleral buckling for pseudophakic retinal detachment

To assess the functional and anatomical outcome of primary vitrectomy without scleral buckling for rhegmatogenous retinal detachment (RRD) in pseudophakic patients and to present the learning curve for this surgery in less experienced surgeons. We reviewed the charts of pseudophakic patients treated with primary vitrectomy without scleral buckling for a rhegmatogenous retinal detachment with PVR < C in two academic centres by four surgeons (two more experienced and two less experienced surgeons) for 1 year. The primary endpoint was the reattachment rate with a single procedure by less experienced and more experienced surgeons. Then, to assess the learning curve of this treatment, we compared the results obtained in consecutive pseudophakic patients by less experienced surgeons at the beginning and after a 2-year training period. First, 133 patient charts with a minimum follow-up of 6 months were included. Retinal reattachment was achieved with a single surgery in 75.2% for all surgeons. This rate was 80.9% for more experienced surgeons compared to 70% for less experienced surgeons (p = 0.37). In another series of 239 patients operated on by less experienced surgeons, the success rate obtained at the beginning of the training period for less experienced surgeons significantly increased after 2 years (from 66.7% to 80%, p < 0.049). Primary vitrectomy without scleral buckling is an effective procedure to treat pseudophakic retinal detachment. Less experienced surgeons need sufficient time to achieve acceptable success rates, reflecting the learning curve for this procedure.