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M. Casillas Gil, I. Hubert, R. Ouled Moussa, K. Angioi Duprez, J. Berrod; Primary Phacovitrectomy Without Scleral Buckling for Rhegmatogenous Retinal Detachment. Invest. Ophthalmol. Vis. Sci. 2010;51(13):6060.
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© ARVO (1962-2015); The Authors (2016-present)
To review the results and complications of primary phacovitrectomy without scleral buckling for rhegmatogenous retinal detachment.
Retrospective review of 99 patients who underwent phacoemulsification and primary vitrectomy for rhegmatogenous retinal detachment.
A significant cataract was present in 14%. Forty one percent of patients had an axial length greater than 26 mm. The average extent of retinal detachment was 3 quadrants, with 86 (87%) eyes with macular involvement. There was 33 (33%) retroequatorial breaks, with 9 (9%) macular hole. During surgery, 3 (3%) unadvertent ruptures of the posterior capsule and 1 (1%) zonular desinsertion occured, and 1 (1%) spontaneous choroidal haemorrhage was noted. Reattachment rate was 83.8% after one procedure, and 93.9% at final examination. Best corrected visual acuity improved from 2.09 logMar preoperatively to 0.63 logMar postoperatively for the whole cohort. Postoperative complications included fibrinous uveitis (16%), iris posterior synechiae (6%), transient intraocular pressure rise (12%), iris/intraocular lens capture (4%) and posterior capsular opacification (14%).
Combined phacoemulsification and primary vitrectomy without scleral buckling provides satisfactory anatomic and functional success rate. The main advantage is to avoid a second procedure for cataract extraction.
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