A 44-year-old woman presents with a sudden unilateral curtain of vision loss. Fundus shows a corrugated, rhegmatogenous retinal detachment involving the macula. B-scan confirms subretinal fluid. She is a −3.0 D myope. The MOST appropriate primary surgical repair is:
- A Pneumatic retinopexy
- B Scleral buckling
- C Pars plana vitrectomy with gas tamponade ✓
- D Combined scleral buckling and vitrectomy
Explanation
For a macula-off rhegmatogenous retinal detachment, pars plana vitrectomy (PPV) with internal tamponade (gas or silicone oil) is the preferred approach in most modern vitreoretinal centers because it allows complete visualization, relief of vitreoretinal traction, and direct retinopexy. Scleral buckling is preferred for young phakic patients with simple inferior breaks, but for macula-off detachments especially with myopia, PPV offers better outcomes. Pneumatic retinopexy has strict criteria (single superior break <1 clock hour) and is not appropriate for macula-off detachments. Combined buckling+vitrectomy is reserved for complex cases with proliferative vitreoretinopathy.
Reference: Khurana Comprehensive Ophthalmology, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.