Vitrectomy Combined with Scleral Buckling in Patients with Inferior Retinal Breaks

Eyes with minimal PVR and anteriorly located break(s) can be successfully managed by pneumatic retinopexy, scleral buckle or vitrectomy while eyes with posterior break(s) or significant PVR need vitrectomy along with tamponading gas or oil2. The specific gravities of most of the internal tamponading agents are less than balanced saline solution. That is why oil or gas bubble floats at the top most position, pressing the retina and providing a tamponade for superior retina. However, its effect on the inferior retina is not enough to press the retina down to pigment epithelium layer and it fails to provide a tamponade3. This poses a problem in managing patients having high grade PVR and inferior breaks, since neither scleral buckle nor vitrectomy alone can keep the retina attached.