Dr Mali Okada is a consultant at the RVEEH and senior researcher at CERA. In this podcast she discusses the various management options of retinal detachment. Pneumatic retinopexy is routinely used as the first line treatment in many parts of the world for superior retinal detachments, but this is not always the case in Australia and New Zealand, where vitrectomy is preferred. The PIVOT study unpacks the issues, looking at repeat visits, surgical and visual outcomes, requirement for follow-up cataract surgery and more. The study has some limitations but is thought-provoking. It is essential to define the markers of success to support surgeons in determining the best course of action for their patients.