Optometry & Vision Science

The treatment options for a primary retinal detachment will be analyzed by starting with Gonin in 1930 up to present in regard

to their morbidity, rate of reoperation and long-term visual function. There had been a change from surgery of the entire retinal

detachment to a surgery limited to the area of then retinal break and as well a change from an extraocular to an approach for

reattaching the retina. Over the last decades there had been evolved four major surgical techniques for repair of a primary retinal

detachment being applied in the beginning of the 21st century. All of these have still one issue in common: To find and close the

retinal break which causes the detachment and which would cause a redetachment, if not sealed off sufficiently. In conclusion,

to find and close the break(s) appropriately in a primary retinal detachment has accompanied the efforts of retinal detachment

surgeons during the past eight decades which is still the “conditio sine qua non” for long-term reattachment. But, however, today four

postulates have to be fulfilled for each of the four techniques for repair that includes; Retinal reattachment should be achieved with

the 1st operation; the procedure should have a minimum of morbidity; it should not harbor secondary complications jeopardizing

regained visual acuity and; it should be performed on a small budget in local anesthesia. This is needed, because the budget for

ophthalmology of today has to cover as well very expensive and long-term needed treatment modalities for AMD.