Clinical Ophthalmology (Aug 2018)
Repair of primary RRD – comparing pars plana vitrectomy procedure with combined phacovitrectomy with standard foldable intraocular lens implantation
Abstract
Sirpa Loukovaara,1 Jari Haukka2 1Unit of Vitreoretinal Surgery, Department of Ophthalmology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; 2Department of Public Health, University of Helsinki, Helsinki, Finland Background: Pars plana vitrectomy (PPV) combined with phacoemulsification and primary intraocular lens implantation can be performed for the repair of primary rhegmatogenous retinal detachment (RRD; PHACOVIT group). The safety and efficacy of this combined ophthalmic procedure on RRD surgery outcomes remain unclear compared with more conventional PPV technique alone (VITRET group). We explored the need for reoperation after primary surgical procedure in these two groups. Methods: Retrospective, longitudinal, register-based cohort of RRD patients was operated in University Eye Clinic, Helsinki, Finland, during 2008–2014. The main outcome measure was reoperation rate during a postoperative follow-up period of 1 year due to retinal re-detachment, vitreous rehemorrhage, postoperative endophthalmitis, secondary pucker, macular hole or other reasons. Results: We analyzed 1,690 consecutive RRD cases, out of which 1,564 patients were treated in the PPV VITRET group and 126 patients in the PHACOVIT-operated group. Risk for reoperation was 2.67 times higher in the PHACOVIT group compared to the PPV VITRET group (95% CI 1.85–3.85). Conclusion: The reoperation rate was higher in RRD eyes operated with combined cataract surgery plus PPV, suggesting that RRD eyes should not primarily undergo combined PHACOVIT surgery. Keywords: cataract surgery, rhegmatogenous retinal detachment, proliferative vitreoretinopathy, cohort study, epidemiology, vitreoretinal surgery, statin therapy
