Phacovitrectomy versus Vitrectomy only for Primary Rhegmatogenous Retinal Detachment Repair

Byoung Young Gu; Min Sagong; Woo Hyok Chang

doi:10.3341/jkos.2011.52.5.537

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Gu, Sagong, and Chang: Phacovitrectomy versus Vitrectomy only for Primary Rhegmatogenous Retinal Detachment Repair

Original Article

J Korean Ophthalmol Soc 2011;52(5):537-543.

Published online: 3 August 2011

DOI: https://doi.org/10.3341/jkos.2011.52.5.537

Phacovitrectomy versus Vitrectomy only for Primary Rhegmatogenous Retinal Detachment Repair

Byoung Young Gu, MD, Min Sagong, MD, Woo Hyok Chang, MD

Department of Ophthalmology, Yeungnam University College of Medicine, Daegu, Korea

Address reprint requests to Woo Hyok Chang, MD Department of Ophthalmology, Yeungnam University Medical Center #317-1 Daemyeong-dong, Nam-gu, Daegu 705-717, Korea Tel: 82-53-620-3443, Fax: 82-53-626-5936, E-mail: changwh@ynu.ac.kr

Received 5 October 2010 Accepted 21 October 2010

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To compare the outcomes of phacovitrectomy and vitrectomy only for treatment of primary rhegmatogenous retinal detachment.

Methods

The anatomical success, functional success, and complications between Group I patients who underwent vitrectomy only and Group II patients who underwent phacovitrectomy for primary rhegmatogenous retinal detachment were retrospectively compared.

Results

Twenty-one eyes (84.0%) in Group I had reattachment after vitrectomy only, and 27 eyes (90.0%) in Group II had reattachment after phacovitrectomy. However, the differences in the measures attributes were not statistically significant (p = 0.271). The logMAR visual acuity improved in both groups with no statistically significant difference between the two groups (p = 0.102). Postoperative complications included cataract progression in 20 eyes (80.0%) in Group I and 17 of the 20 eyes (68.0%) underwent cataract surgery within one year after the first surgery.

Conclusions

Phacovitrectomy, irrespective of severe lens opacity, is a relatively effective combined surgical procedure in older patients with primary rhegmatogenous retinal detachment and impending presbyopia. The procedure allows for easy access to the periphery during vitreous shaving and prevents the need for a second cataract operation.

Keywords: Phacoemulsification, Phacovitrectomy, Rhegmatogenous retinal detachment, Vitrectomy

References

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Figure 1.

BCVA change of two groups. ^* BCVA = best cor-rected visual acuity.

Table 1.

Demographics and clinical data of the patients

	Vitrectomy (n = 25)	Phacovitrectomy (n = 30)	p-value
Sex (M/F)	21/9	20/10	0.612
Age (mean ± SD, yr^* [range])	53.56 ± 12.57 (40-77)	55.8 ± 11.91 (40-78)	0.382
Follow up (mean ± SD, mon)	13.08 ± 3.17	12.59 ± 3.91	0.448
Duration of symptoms (mean ± SD, day)	7.56 ± 3.06	8.28 ± 4.41	0.250
Preoperative cataract (%)	9 (36.0%)	11 (36.7%)	0.960
Preoperative BCVA^† (mean ± SD, logMAR)	1.53 ± 1.01	1.43 ± 1.04	0.619

^* SD = standard deviation;

^† BCVA = best corrected visual acuity.

Table 2.

Macular status and tear positions in each group

	Vitrectomy (n = 25)	Phacovitrectomy (n = 30)	p-value
Macula on/off detachment
On	18 (64.0%)	21 (70.0%)	0.622
Off	7 (36.0%)	9 (30.0%)
Tear position
Superotemporal	15 (60.0%)	15 (50.0%)	0.462
Others	10 (40.0%)	15 (50.0%)

Table 3.

Postoperative complications

	Vitrectomy (n = 25)	Phacovitrectomy (n = 30) 　 p	p-value
IOP^* elevation	16.0% (4/25)	20.0% (6/30)	0.704
Cataract	80.0% (20/25)	0%	x
PCO^†	0%	16.7% (5/30)	x
Iris/IOL^‡ capture	0%	13.3% (4/30)	x
Retinal redetachment	16.0% (4/25)	10.0% (3/30)	0.51
Fibrinous uveitis	0%	6.7% (2/30)	x
Macular ERM^§	8.0% (2/30)	3.3% (1/30)	0.452
Hyphema	0%	3.3% (1/30)	x

^* IOP = intraocular pressure;

^† PCO = posterior capsular opacification;

^‡ IOL = intraocular lens;

^§ ERM = epiretinal membrane.

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