Repair of a primary rhegmatogenous retinal detachment

An emmetropic otherwise well 67 year old man, with no history of eye disease, presents with a rhegmatogenous retinal detachment. The patient needs surgery to repair the detachment. There are three major techniques available to repair the detachment— scleral buckling without drainage, primary vitrectomy, and pneumatic retinopexy. In determining which surgical technique to choose, there are a number of clinical features to consider such as the location and size of the retinal breaks, the presence of media opacities such as cataract, and the presence of proliferative vitreoretinopathy. Additionally, the training and experience of the surgeon is important. Who should perform the surgery? Which technique should be used? The three invited experts present the case for each technique and discuss their relative advantages and disadvantages.