Purpose:
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).
Methods:
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.
Results:
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.
Conclusions:
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.
Keywords: retinal detachment • vitreoretinal surgery