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Ik Soo Byon, Seung Min Lee, Gang Yun Park, Ji Eun Lee, Boo Sup Oum; Lens-Save Versus Phacoemulsification with Intraocular Lens Implantation in Primary Vitrectomy for Phakic Rhegmatogenous Retinal Detachment. Invest. Ophthalmol. Vis. Sci. 2012;53(14):4606.
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This study aimed to compare the outcomes of lens-save vitrectomy versus concurrent cataract surgery in the primary vitrectomy for phakic rhegmatogenous retinal detachment (RRD).
We carried out a retrospective case control study of 54 patients undergoing primary vitrectomy for phakic RRD with a minimum of 12-month follow-up. Group 1 (n=20) underwent a lens-save vitrectomy and Group 2 (n=34) underwent vitrectomy and phacoemulsification simultaneously. Best-corrected visual acuity, anatomical success rate, lens status and postoperative complications were evaluated. Lens status was estimated using the classification of LOCSIII.
Baseline demographic and preoperative ocular characteristics showed no statistically significant difference between two groups except age (49.6±11.9 vs 62.4±8.2) and lens status (1.8±0.9 vs 3.18±0.87). Mean follow-up period was 32.5±13.2 months for the group 1 and 33.3±18.5 months for the group 2. Postoperative visual acuity (1, 3, 6 and 12 months) improved significantly in both group (p<0.05), and there was no statistical difference between two groups. Reattachment was achieved with single surgery in 90.0% and 94.1% respectively. Significant cataract developed from 3 months in the group 1. Cataract surgery was required in 2 eyes by 3 months and in 13 eyes (65.0%) at a mean follow-up time of 23.2±12.9 months. Visual acuity improved significantly after cataract surgery (p<0.05). Baseline age and lens status did not have correlation with anatomical and functional outcomes of two groups.
Whether the lens was saved or not, anatomical and functional outcomes were good after primary vitrectomy for phakic RRD. However high incidence of significant cataract progression was noted in long-term follow-up in Group 1. Concurrent cataract surgery should be considered in primary vitrectomy for phakic RRD, except young patients who need a fine accommodation.
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