To compare the surgical outcomes of 23-gauge transconjunctival sutureless vitrectomy (TSV) with silicone oil tamponade versus 20-gauge PPV with sclera buckling (SB) and SF6 gas tamponade for the repair of rhegmatogenous retinal detachment (RRD) with inferior breaks. In addition, silicone oil tamponade was evaluated as an alternative option for patients with inferior RRD.

Two different types of surgery were performed on two groups of patients with inferior RRD: 23-gauge TSV with silicone oil tamponade (group 1) and 20-gauge PPV with SB and SF6 gas tamponade (group 2). The preoperative clinical features, anatomical success rate, complications, functional outcomes (visual acuity, VA, intraocular pressure, IOP), and surgical time were retrospectively evaluated.

The primary surgical success rates were 94% and 78% in groups 1 and 2, respectively. The final success rate was 100% in both groups. Therefore, in terms of success rate, there was no difference between the two groups. No statistically significant difference in IOP change or complication rate was observed between the two groups. VA change was significantly better and surgical time was shorter in group 1.

No statistically significant difference of anatomical success rate or complication rate between 23-gauge TSV with silicone oil tamponade and 20-gauge PPV with SB and SF6 gas tamponade was found for inferior RRD. However, surgical time was shorter in group 1. A 23-gauge TSV with silicone oil tamponade could be an alternative to 20-gauge PPV with SB and SF6 gas tamponade for patients with inferior RRD, especially patients who cannot maintain a prone posture.