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Diane Bernheim, Palombi Karine, Rouberol Frederic, Albrieux Magaly, Romanet Jean-Paul, Chiquet Christophe; Comparative Prospective Study Of Phakic And Pseudophakic Rhegmatogenous Retinal Detachments In High Myopia. Invest. Ophthalmol. Vis. Sci. 2011;52(14):6158.
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to compare anatomic and functional results of primary rhegmatogenous retinal detachment (RD) in highly myopic phakic or pseudophakic eyes. From the included, 225 patients with high myopia were reported, 34 patients were excluded (follow-up loss, or exclusion criteria). So the 191 remaining patients (151 phakics and 40 pseudophakics) were assessed for a minimal 6 months follow-up examination.
This prospective, bi-centric study included 191 consecutive eyes (151 phakic and 40 pseudophakic eyes) from a prospective cohort of patients 835 patients (IRB #5891, between 2004 and 2008). Surgery (pars plana vitrectomy (PPV) or scleral buckling (SB)) was left to the surgeon choice. Baseline and follow-up data were systematically recorded at presentation, 1 and 6 months or more after surgery. On final examination two groups were considered: single or multi-surgery for total retinal reapplication. The endpoints were the primary reattachment rate at the 6-month visit; the final anatomical success rate, the postoperative VA and intra- and postoperative complications.
The analysis showed 96% primary reattachment, and 54% (after one surgery) or 44% (multi-surgery) good visual outcome (VA ≥20/40). Pseudophakic eyes differed from phakic eyes by age (60.8±10.4 vs 49.9±12.3 p<0.001), smaller pupil dilation (8.0±1.5 mm vs 8.5±1.2 mm p=0.02), a fewer number of retinal tears seen pre-operatively (1.5±1.6 vs 2.2±2.2 0.06), more frequently use of PPV (80% vs 28.5%, p<0.001) and a higher rate of single reattachment rate (92.5% vs 80.7%).
This prospective study showed similar baseline RD characteristics of high myopic phakic or pseudophakic eyes, suggesting that high myopia is in both groups the main pathogenic factor. Despite a primary reattachment rate higher for pseudophakic eyes, thee functional prognosis is the same in the two groups after single or multi-surgery and close to that described in emmetropic eyes. Despite their anatomic particularities and per-operative morbidity risks factors reported in 2010, high myopic eye finally developed few intra or postoperative complications.
Clinical Trial: :
http://www.clinicaltrials.gov (IRB #5891
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