PurposeTo investigate the outcome after combined phaco-vitrectomy in rhegmatogenous retinal detachment (RRD) repair.Patients and methodsIn this retrospective study, we included all patients who underwent pars plana vitrectomy (PPV) for RRD between January 2013 and December 2017. The main outcome measure was the retinal re-detachment rate after combined phaco-vitrectomy.ResultsOverall, 1017 eyes with RRD were included. All eyes received PPV, while in 516 eyes additional phacoemulsification was performed. A retinal re-detachment occurred in 103 patients (10.1%). No significant difference in the rate of re-detachment was found if additional phacoemulsification was performed (p=0.641). Subgroup calculations showed a significant higher rate of re-detachment in patients with a PVR (p=0.0003) and in patients where silicone oil was used as primary tamponade (p=0.0001) as well as in macula off RRDs (p=0.034).ConclusionAdditional phacoemulsification during vitrectomy for RRD is not associated with higher rate of retinal re-detachment.
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Purpose: To investigate clinical and surgical factors influencing the outcome after primary rhegmatogenous retinal detachment surgery. Methods: A retrospective, single-centre, case-control study of 1017 eyes of 1017 consecutive patients with primary rhegmatogenous retinal detachment (RRD) who underwent pars plana vitrectomy (PPV), were included in the study. Analysed surgical factors were: combined procedure with phacoemulsification, type of retinopexy (cryocoagulation, endolaser, combined), type of tamponade (gas, silicone oil), and anatomical factors: primary proliferative vitreoretinopathy (PVR) and macular detachment at the time of surgery. Results: Overall retinal re-detachment rate was 10.1%. The main reason for re-detachment was an insufficient retinopexy in 53.6%, followed by PVR (37.3%), and retinal detachment occurred at a different location caused by another break in 9.1%. No significant difference in the rate of re-detachment was found if a phacoemulsification with simultaneous IOL implantation was performed (p = 0.641). No significant difference between the various retinopexy techniques was found (p = 0.309). Risk factors re-detachment were primary PVR (p = 0.0003), silicone oil as initial tamponade (p = 0.0001) as well as macula off detachments (p = 0.034). Conclusions: The present study showed no significant difference between the types of retinopexy and if additional phacoemulsification was performed or not. Factors associated with a higher risk for re-detachment were detached macula at surgery, primary PVR and primary oil-filling.
Background To investigate the influence of different types of retinopexy on the outcome of rhegmatogenous retinal detachment (RRD) repair. Method All patients with RRD who underwent pars plana vitrectomy (PPV) between January 2013 and December 2017 were included. Analysed surgical factors were types of retinopexy (cryocoagulation, endolaser, combined). Subgroup analysis was performed in patients with primary proliferative vitreoretinopathy (PVR), and/or the necessity of a primary silicone oil fill. Results A total of 1017 eyes with retinal detachment were included. The predominant type of retinopexy used during PPV was cryocoagulation in 492 eyes, followed by a combined cryocogulation/endolaser in 306 eyes and laserretinopexy in only 219 eyes. Overall, the re-detachment rate was 10.1%. In most of the cases (53.6%) the main reason for re-detachment was insufficient retinopexy, followed by a PVR-reaction in 37.3%, and new site break in 9.1%. No significant difference in the rate of re-detachment was found between the different types of retinopexy ( p = 0.309). However, subgroup analysis showed a significantly higher rate of re-detachment in patients with a primary PVR ( p = 0.0003), and in the group with silicone oil as the primary tamponade ( p = 0.0001). Conclusion The data suggests that the type of retinopexy has little relevance for the surgical outcome of PPV for the primary RRD. However, patients with primary PVR and primary silicone oil fills were at a significantly increased risk for re-detachment.
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