To evaluate the surgical outcomes of primary 23-gauge (23G) transconjunctival sutureless vitrectomy (TSV) with air tamponade in patients with idiopathic simple rhegmatogenous retinal detachment (RRD).

A chart review of 38 eyes with idiopathic simple RRD which underwent primary 23G TSV with air tamponade and without prone positioning by a single vitreoretinal surgeon was retrospectively performed. All cases were followed up for a minimum of 3 months after the operation.

The primary anatomical success rate was 94.7% (36/38 eyes). Preoperative mean logMAR (Snellen) best corrected visual acuity (BCVA) was 0.81 ± 0.13 and improved to 0.63 ± 0.37 and 0.48 ± 0.37 at postoperative 1 week and 3 months ( p < 0.05), respectively. The mean 21.35% amount of air bubble remained in the vitreous cavity at postoperative 1 week and the residual air bubble was completely absorbed at postoperative 2 weeks. Complications were sclerotomy site leakage (1 eye), cataract (3 eyes), vitreous hemorrhage (1 eye), epiretinal membrane (2 eyes) and increased intraocular pressure (3 eyes).

The use of 23G TSV with air tamponade in cases with idiopathic simple RRD may be an effective and safe surgical technique.