J Korean Ophthalmol Soc.  2015 Mar;56(3):357-364. 10.3341/jkos.2015.56.3.357.

Phacovitrectomy versus Phacoemulsification after Vitrectomy for Rhegmatogenous Retinal Detachment Repair

• Choi AY
• Yeo Y
• Kim YC

• KMID: 2339041
• DOI: http://doi.org/10.3341/jkos.2015.56.3.357

Abstract

PURPOSE
To compare the outcomes of phacovitrectomy and phacoemulsification after vitrectomy for treatment of rhegmatogenous retinal detachment (RRD).
METHODS
We performed a retrospective comparative analysis of 39 consecutive eyes with phakic primary RRD followed up for more than 6 months. The patients were divided into phacoemulsifcation after vitrectomy and phacovitrectomy groups. The main outcome measures were the best corrected visual acuity (BCVA), anatomical success rate and postoperative complications.
RESULTS
The mean age was 54.17 years in the phacoemulsifcation after vitrectomy group (n = 23) and 56.69 years in the phacovitrectomy group (n = 16; p = 0.031). The log MAR BCVA improved in both groups with no statistically significant difference between the 2 groups (p = 0.592). The anatomical success rate after initial surgical intervention was 100% in both groups. Retinal detachment recurred in 3 eyes in the phacoemulsifcation after vitrectomy group; caused by new retinal tear.
CONCLUSIONS
The new RRD rate in phacoemulsification after vitrectomy group was higher than in the phacovitrectomy group. Due to the retrospective and limited data in this study, whether simultaneous combined cataract surgery with retinal detachment surgery should be recommended to reduce RRD risk is inconclusive and further larger, prospectively designed studies are necessary to confirm the present findings.

Keyword

Phacoemulsification; Phacovitrectomy; Retinal re-detachment

MeSH Terms

Cataract
Humans
Outcome Assessment (Health Care)
Phacoemulsification*
Postoperative Complications
Retinal Detachment*
Retinal Perforations
Retrospective Studies
Visual Acuity
Vitrectomy*

Figure

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  Figure 1. BCVA change of 2 groups. BCVA = best corrected visual acuity.

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  Figure 2. Intraocular tamponade of 2 groups.

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  Figure 3. Fundus findings before vitrectomy surgery (A, C, E) and after cataract surgery (B, D, F) of three patients with retinal redetachment after cataract surgery. E: Two horseshoe tears are observed but definite retinal detachment border is not identified due to vitreous hemorrhage. Blue: detached retina; red: new retinal tear; brown: old retinal tear; green: vitreous hemorrhage.

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  Figure 4. New retinal tear caused by traction (red arrow) on any remaining anterior hyaloids.

Reference

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