OBJECTIVE: For the primary treatment of pseudophakic retinal detachment, vitrectomy could be preferred to episcleral buckle because it does not induce myopia, it clears opacities of the posterior capsule and/or of the vitreous and allows a good visualization of the fundus. This study was determined to compare the anatomic and functional results of vitrectomy and episcleral buckle. METHODS: from 1990 to 1995, 93 pseudophakic eyes were operated on for retinal detachment. 75 eyes were treated with episcleral buckle (group I) and 18 eyes were treated with vitrectomy (group II). In the latter group, 4 eyes had a giant tear, and 4 other eyes had a macular hole associated with high myopia. The anatomic and functional results were analyzed retrospectively. RESULTS: The retina was reattached with one operation in 67 eyes of group I (89%) and 16 of group II (89%). More than one month after the first operation, the retina redetached in 6 eyes of Group I (8%) and one eye of group II (6%). The causes of failure were a) new or missed retinal tears [Group I: 10 eyes (13%), group II: 3 eyes (17%)] and b) vitreoretinal proliferation (group I: 4 eyes, group II: 0). The number of subsequent reoperations for failures or recurrences was higher in group I than in group II. At the final examination, the retina was attached in 73 eyes of group I (97%) and in 18 eyes of group II (100%). The Kruskal-Wallis test did not detect any difference between the two groups concerning the pre- or postoperative visual acuities. CONCLUSION: Vitrectomy seems as effective as episcleral buckle for the treatment of pseudophakic retinal detachment and offers additional advantages.