We read with interest the recent article by Arroyo and associates.1 They are to be commended on a very interesting study to compare the visual and anatomical outcomes of patients who underwent primary scleral buckle placement during posterior segment open globe repair with matched control patients who did not undergo primary scleral buckle placement. Prophylactic scleral buckle of posterior segment open globe injuries has been a controversial topic in ophthalmology. The value of scleral buckling to support peripheral and especially inferior breaks is rarely disputed. However, the utility of using an encircling buckle in the absence of retinal breaks remains controversial. The benefits of primary scleral buckle placement are that it …