Optimizing surgical treatments in rhegmatogenous retinal detachment

Rhegmatogenous retinal detachment (RRD) is an important cause of visual impairment and one of the most common ocular emergencies threatening vision. Timely surgical intervention is crucial to prevent permanent visual loss. The fundamental principles used in the surgical management of RD are the identification and subsequent closing of all retinal breaks, and relieving vitreous traction on the retina. Most of the early postoperative redetachment was due to an inability to achieve one or both of these objectives. Although the cause of a late failure in RD is difficult to identify, the most commonly reported one is proliferative vitreoretinopathy.1 It is therefore important to use the most appropriate surgical approach for patients with RRD, minimizing the risk of visual loss due to these surgical failures. In the review article, “Primary retinal detachment: a review of the development of techniques for repair in the past 80 years”, Ingrid Kreissig presented a concise overview of the evolution of surgical techniques used to reattach primary RD. Furthermore, current techniques were also analyzed with regard to their effect on morbidity, reoperation, and long-term visual function. This article provides an excellent review related to historical perspectives on the management of RD. Kreissig reviewed the first conceptual progress in the treatment of RD, postulated by Jules Gonin 90 years ago, that a retinal break is the main cause of RD and applied ignipuncture around the break hopefully to seal the break and reattach the retina. In 2015, Albert et al2 wrote an article on Jules Gonin in Ophthalmology. They described how he could serve as a role model for future scientists taking on audacious goals. He is admired not only for his high level of intelligence, but also for his creativity, networking skills, ability to take risks, and capability to adapt.