Primary retinal detachment: A review of the development of techniques for repair in the past 80 years☆

BACKGROUND/PURPOSE The evolution of present surgical techniques for reattaching a primary retinal detachment will be reviewed starting from 1929, and the present techniques analyzed in regard to their morbidity, reoperation, and long-term visual function. METHODS Literature of retinal detachment operations during the past 80 years is reviewed, of which the author has first-hand experience during the past 40 years. There had been a change from surgery of the entire detachment to a surgery limited to the retinal break and a change from extraocular to intraocular surgery. RESULTS The four major operations for repair of a primary retinal detachment in use at the beginning of the 21st century, have still one thing in common for sustained reattachment: to find and close the break that caused the primary retinal detachment and that would cause a redetachment, if not sealed completely. This is independent of whether the surgery is limited to the break or extends over the entire detachment and the same is true whether the surgery is performed as an extraocular or intraocular procedure. CONCLUSION To find and close sufficiently the break in a primary retinal detachment has accompanied the efforts of retinal detachment surgeons during the past 80 years. This is still the premise for sustained reattachment. However, today four postulates have to be fulfilled: (1) retinal reattachment with the first operation; (2) the procedure should have a minimum of morbidity; (3) the procedure should not harbor secondary complications jeopardizing regained visual acuity; and (4) the procedure should be performed on a small budget with local anesthesia.