Background: The Researchers have compared the safety and effectiveness of pars plana vitrectomy with scleral buckle (PPV-SB) to pars plana vitrectomy (PPV) without scleral buckle, and the use of scleral buckle is only a matter of discussion among surgeons when it comes to complex retinal detachment surgery. In instances with inferior retinal break complicated with Proliferative Vitreoretinopathy, this study aimed to compare the surgical outcomes of combination PPV-SB versus PPV alone using optical coherence tomography (PVR). We used a prospective, randomised controlled trial design to examine the outcomes of surgical repair of retinal detachment in 58 eyes that had an inferior break and posterior vitreous recession (PVR) (RD). Each patient was randomly assigned to one of two groups: Treatment in Group A included both PPV and SB. Only PPV was performed on Group B. The results showed that in group A, there were no notable differences between the two groups in terms of age, sex, laterality, axial length < 26mm, intraocular pressure (IOP) before surgery, IOP three months later, lens status before surgery, macula status before surgery, and preoperative posterior vitreous refraction grading. Individuals in group B who had a successful single surgery had axial lengths that were noticeably greater than 26mm. There were no notable changes between the groups in terms of age, sex, laterality, intraocular pressure (IOP) before surgery, IOP three months after surgery, lens status before surgery, macula status before surgery, or preoperative visual acuity (PVR) grade. Conclusion: For patients with inferior breaks and PVR, restoring retinal detachment can be accomplished with either PPV alone or PPV combined with SB. Both surgical techniques are valid and have comparable outcomes.