Open Access

Isabel Habert, Arthur Mueller, Y. Botros, R. Khoramnia, Isabella D. Baur

• Background Rhegmatogenous retinal detachment (RRD) is a potentially acute vision-threatening condition. While scleral buckling (SB) was considered the standard treatment for decades, it has increasingly been replaced by pars plana vitrectomy (ppV). Objective This study aims to re-evaluate the role of SB within the current therapeutic context by comparing the clinical outcomes of SB versus primary ppV for RRD, based on data published from 2005–2025. Material and methods A systematic literature search across five databases identified 24 studies (2005–2025) comparing SB and ppV in primary RRD. Exclusion criteria included patient age under 18 years and proliferative vitreoretinopathy (PVR) greater than grade B. Outcomes were analyzed in terms of preoperative and postoperative corrected distance visual acuity (CDVA) and single surgery anatomical success (SSAS). Results Across all included studies the mean preoperative CDVA was 1.22 logMAR. Postoperatively, visual acuity improved toBackground Rhegmatogenous retinal detachment (RRD) is a potentially acute vision-threatening condition. While scleral buckling (SB) was considered the standard treatment for decades, it has increasingly been replaced by pars plana vitrectomy (ppV). Objective This study aims to re-evaluate the role of SB within the current therapeutic context by comparing the clinical outcomes of SB versus primary ppV for RRD, based on data published from 2005–2025. Material and methods A systematic literature search across five databases identified 24 studies (2005–2025) comparing SB and ppV in primary RRD. Exclusion criteria included patient age under 18 years and proliferative vitreoretinopathy (PVR) greater than grade B. Outcomes were analyzed in terms of preoperative and postoperative corrected distance visual acuity (CDVA) and single surgery anatomical success (SSAS). Results Across all included studies the mean preoperative CDVA was 1.22 logMAR. Postoperatively, visual acuity improved to 0.49 logMAR with SB and to 0.5 logMAR with ppV. In phakic eyes, SB resulted in an average postoperative CDVA of 0.17 logMAR, whereas ppV achieved a mean of 0.23 logMAR in the same subgroup. The SSAS was reported to be up to 93.8% for SB and up to 96.3% for ppV. Conclusion Scleral buckling remains an effective therapeutic option for selected patient populations, particularly those with a phakic lens status. Given its clinical relevance, SB should continue to be an integral part of surgical training programs.…