Abstract
Purpose:
To evaluate the overall refractive outcomes after combined phacoemulsification and pars plana vitrectomy(PPV) between rhegmatogenous retinal detachment(RRD) and other retinal disease.
Methods:
Total of 60 patients who had combined surgery between January 2007 to December 2012 at Hallym sacred heart hospital were enrolled in the study. The 25 patients who received combined surgery for RRD were included in RD group and 35 patients who underwent combined surgery for other vitreoretinal pathology were included in control group. Refractive, axial length(AL), Intraocular pressure(IOP) measurements were performed preoperatively, 3months and 6months postoperatively. AL was matched between two groups and the factors influencing the postoperative refractive outcomes were analyzed.
Results:
Mean difference between the actual and expected postoperative 6months refractive outcome in RD and control group was -0.43diopter(D) ± 0.67(SD) (P=0.046) and -0.08 ± 0.53(D), respectively. (P =0.767) Mean preoperative IOP in affected eye and fellow eye in RD group was 11.44mmHg ± 3.15 and 13.16mmHg ± 2.73, respectively; the difference was significant. (P=0.045) But no difference was found in affected eye and fellow eye in control group. It was 14.20mmHg ± 2.95 and 14.17mmHg ± 3.50, respectively. (P=0.974) Mean postoperatively 3months and 6months IOP in affected eye and fellow eye of two groups were not significantly different. For all eye, the refractive difference correlated to IOP change in RD group. (r=0.659, r2=0.435, P<0.001)
Conclusions:
The postoperative refraction in RD group shifted toward myopia by a mean of 0.35(D) compared with that after combined surgery in control group. Normalizing preoperative lowered IOP after combined surgery in RRD may be the key factor to understand this myopic shift.
Keywords: 697 retinal detachment •
676 refraction •
568 intraocular pressure