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

Soo Byon Ik; Yeun Pak Kang; Yeun Pak Kang; Min Lee Seung; Eun Lee Ji; Sup Oum Boo

doi:10.3341/jkos.2013.54.3.449

Journal List > J Korean Ophthalmol Soc > v.54(3) > 1009619

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Ik, Kang, Kang, Seung, Ji, and Boo: Lens-Save Versus Phacoemulsification with Intraocular Lens Implantation in Primary Vitrectomy for Phakic Rhegmatogenous Retinal Detachment

Original Article

J Korean Ophthalmol Soc 2007;54(3):449-455.

Published online: 24 August 2007

DOI: https://doi.org/10.3341/jkos.2013.54.3.449

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

Soo Byon Ik, MD¹, Yeun Pak Kang, MD¹, Yeun Pak Kang, MD¹, Min Lee Seung, MD¹, Eun Lee Ji, MD, PhD^1,^2,, Sup Oum Boo, MD, PhD^1,²

¹Department of Ophthalmology, Pusan National University Hospital, Busan, Korea

²Department of Ophthalmology, Pusan National University School of Medicine, Yangsan, Korea

Address reprint requests to Ji Eun Lee, MD, PhD Department of Ophthalmology, Pusan National University Hospital #179 Gudeok-ro, Seo-gu, Busan 602-739, Korea Tel: 82-51-240-7326, Fax: 82-51-242-7341, E-mail: jlee@pusan.ac.kr

Received 26 July 2006 Accepted 8 May 2007

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 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.

Keywords: Cataract, Combined surgery, Phakic rhegmatogenous retinal detachment, Vitrectomy

References

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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.

Table 1.

Baseline characteristics

	Vitrectomy group (n = 20)	Combined group (n = 34)	p-value
Gender (M/F)	9/11	12/22	0.480^*
Age (mean ± SD)	46.9 ± 11.6	60.5 ± 8.2	<0.001^†
BCVA (mean ± SD, log MAR)	1.27 ± 1.15	1.30 ± 1.04	0.794^†
LOCSⅢ score (mean ± SD)	1.8 ± 0.79	3.2 ± 0.87	<0.001^†
Macular status			0.812
Macular on	7	13
Macular off	13	21
Location of breaks			0.411^‡
Inferior	4	4
Non- inferior	16	30
Type of vitrectomy			0.024
20 gauge	14	13
23 gauge	6	21

Values are presented as mean ± SD.

^* Chi square test;

^† Mann-Whitney U-test;

^‡ Fisher exact test.

Table 2.

Postoperative complications

	Vitrectomy group (n = 20)	Combined group (n = 34)	p-value
Elevation of IOP	20.0% (4/20)	47.1% (16/34)	0.079^*
Cells in anterior chamber (≥1+)	35.0%(7/20)	94.1% (32/34)	<0.001^*
Fibrous membrane in anterior chamber	5.0% (1/20)	8.8% (3/34)	1.000^*
Retinal re-detachment	10.0% (2/20)	5.9% (2/34)	0.622^*
Optic capture	NA^†	5.9% (2/34)	0.525^*
Macular pucker	20% (4/20)	29.4% (10/34)	0.553^*

^* Fisher exact test;

^† Not applicable.

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