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Book and Software Review
January 2006

Primary Retinal Detachment: Options of Repair

Arch Ophthalmol. 2006;124(1):141-142. doi:10.1001/archopht.124.1.141

The purpose, as stated by the editor, is “to enable the retina and vitreous surgeon to participate in the ongoing discussion regarding the best surgical technique for primary retinal detachment repair.” This is the first tome that openly addresses the question and enlists experts to opine why their operation is best. The “best operation,” as defined by the editor, consists of 4 admirable criteria: single operation success, minimum morbidity, cost-effectiveness, and maximum long-term visual function. It is refreshing to note that visual function and cost are finally being considered. I would argue that of these 4, final vision is the most important: the oth ers are significant, but for the ophthalmologist (and the patient), the major concern is vision. Visual acuity (how we perceive a Snellen chart) is not vision (how we perceive the environment in harmony with the fellow eye). A 20/20 single-operation attached retina should not be considered a success if the patient is 20 diopters (D) exotropic and 10 D hypertropic, with 1 D of astigmatism and 3 D of anisometropia, and has persistent epiphora, a dilated pupil, and a chronically uncomfortable eye.

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