J Korean Ophthalmol Soc.  2013 Mar;54(3):449-455. 10.3341/jkos.2013.54.3.449.

Lens-Save Versus Phacoemulsification with Intraocular Lens Implantation in Primary Vitrectomy for Phakic Rhegmatogenous Retinal Detachment

• Byon IS
• Pak KY
• Lee SM
• Lee JE
• Oum BS

• KMID: 2216765
• DOI: http://doi.org/10.3341/jkos.2013.54.3.449

Abstract

PURPOSE
To compare lens-save and simultaneous phacoemulsification with intraocular lens implantation in primary vitrectomy for phakic rhegmatogenous retinal detachment (RRD).
METHODS
A retrospective comparative analysis of 54 consecutive eyes from 54 phakic RRD patients who underwent vitrectomy with a minimum of 12 months of follow-up was performed. The patients were divided into the vitrectomy group and the combined group (patients who underwent vitrectomy with concurrent cataract surgery). The main outcome measures were the best corrected visual acuity (BCVA), anatomical success rate, complications and cataract status according to LOCSIII grading.
RESULTS
Baseline characteristics were similar in both groups, except for age and cataract status. The mean age was 46.9 year in the vitrectomy group (n = 20) and 60.5 years in the combined group (n = 34) (p < 0.001). The postoperative BCVA (log MAR) improved from 1.27 and 1.30 at baseline to 0.45 and 0.28 at 12 months (p < 0.05), respectively, which was not a significant difference between the 2 groups. In the vitrectomy group, cataract status was changed from 1.8 at baseline to 2.5 at 12 months (p = 0.001). Two patients (11.1%) had an additional cataract surgery performed. The primary anatomical success rate was 90.0% in the vitrectomy group and 94.1% in the combined group.
CONCLUSIONS
The vitrectomy group and combined group had similar results in the repair of phakic RRD. Although postoperative cataract progression was noted, lens should be saved in vitrectomy for young patients, as significant cataract is uncommon.

Keyword

Cataract; Combined surgery; Phakic rhegmatogenous retinal detachment; Vitrectomy

MeSH Terms

Cataract
Eye
Follow-Up Studies
Humans
Lens Implantation, Intraocular
Lenses, Intraocular
Outcome Assessment (Health Care)
Phacoemulsification
Retinal Detachment
Retinaldehyde
Retrospective Studies
Visual Acuity
Vitrectomy
Retinaldehyde

Figure

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  Figure 1. A change of the best corrected visual acuity (BCVA) in the vitrectomy group and the combined group. The post-poerative BCVA of both groups significantly improved from 1.27 ± 1.15 and 1.30 ± 1.04 to 0.45 ± 0.37 and 0.28 ± 0.36 at 12 months, respectively (p = 0.001). The BCVA had no significant difference between two groups.

• 

  Figure 2. A change of LOCSⅢ score in the Vitrectomy group. LOCS Ⅲ score increased from 1.8 ± 0.79 to 2.2 ± 0.73 (p = 0.002), 2.4 ± 0.93 (p = 0.004) and 2.5 ± 1.12 (p = 0.001) at 3, 6 and 12 months.

Reference

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