Repair of primary RRD – comparing pars plana vitrectomy procedure with combined phacovitrectomy with standard foldable intraocular lens implantation

Abstract

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

Acknowledgments

This work was supported by TYH2016230 grant (SL) and the University of Helsinki and the National Institute for Health and Welfare, Finland (JH).

Author contributions

JH and SL designed the sub-study. JH performed statistical analyses. SL and JH drafted the manuscript. SL and JH contributed to the conception and design of the study, acquisition and interpretation of the data, and have approved the final version of the work. All authors agree to be accountable for all aspects of the work.

Disclosure

The authors report no conflicts of interest in this work.