Phacovitrectomy versus Phacoemulsification after Vitrectomy for Rhegmatogenous Retinal Detachment Repair

PURPOSE: To compare the outcomes of phacovitrectomy and phacoemulsification after vitrectomy for treatment of rhegmatogenous retinal detachment (RRD). METHODS: We performed a retrospective comparative analysis of 39 consecutive eyes with phakic primary RRD followed up for more than 6 months. The patients were divided into phacoemulsifcation after vitrectomy and phacovitrectomy groups. The main outcome measures were the best corrected visual acuity (BCVA), anatomical success rate and postoperative complications. RESULTS: The mean age was 54.17 years in the phacoemulsifcation after vitrectomy group (n = 23) and 56.69 years in the phacovitrectomy group (n = 16; p = 0.031). The log MAR BCVA improved in both groups with no statistically significant difference between the 2 groups (p = 0.592). The anatomical success rate after initial surgical intervention was 100% in both groups. Retinal detachment recurred in 3 eyes in the phacoemulsifcation after vitrectomy group; caused by new retinal tear. CONCLUSIONS: The new RRD rate in phacoemulsification after vitrectomy group was higher than in the phacovitrectomy group. Due to the retrospective and limited data in this study, whether simultaneous combined cataract surgery with retinal detachment surgery should be recommended to reduce RRD risk is inconclusive and further larger, prospectively designed studies are necessary to confirm the present findings.

Clinical Outcomes After Intraocular Silicone Oil Removal and Analysis of Its Prognostic Factors

PURPOSE: To evaluate the factors influencing clinical outcome after removal of intraocular silicone oil and the relationship of the factors to the postoperative visual prognosis. METHODS: The authors retrospectively analyzed clinical outcomes related to 76 patients (79 eyes) who underwent silicone oil tamponade. Prognostic factors were as follows: age, underlying pathologies, systemic diseases, range and type of retinal detachment (RD), type of RD, number of retinal tears, macular and lens status, and types of operation. The influence of these factors on visual acuity and anatomical success rates were studied. RESULTS: The 79 eyes that underwent silicone oil removal had preoperative diagnoses as follows: proliferative diabetic retinopathy in 32 eyes, primary rhegmatogenous RD in 12 eyes, RD with an intraocular foreign body in nine eyes, traumatic RD in eight eyes, RD with a macular hole in six eyes, RD development after other surgeries in six eyes, RD with endophthalmitis in three eyes, and RD with high myopia in three eyes. Anatomical success was achieved in 59 eyes (74.7%) after silicone oil removal. Thirty-two eyes (40.5%) had an increase in visual acuity, 28 eyes (35.4%) showed no changes and 19 eyes (24.1%) showed deteriorated conditions after silicone oil removal. The number of surgeries was an important factor related to anatomical and functional success rate. Postoperative visual improvement was observed when the number of surgeries was greater than two and in groups with no macular holes or degenerations. CONCLUSIONS: When considering prognostic factors for silicone oil removal, reducing complications and retinal redetachment after silicone oil removal may be helpful.

Clinical Outcomes After Silicone Oil Removal

PURPOSE: To evaluate clinical outcomes after silicone oil removal, we analyzed retinal redetachment, visual acuity, and postoperative complications. METHODS: 73 consecutive eyes who underwent silicone oil removal were studied in a retrospective fashion. 41 eyes with proliferative vitreoretinopathy, 20 eyes with proliferative diabetic retinopathy, 6 eyes with traumatic detachment, 6 eyes with high myopic macular hole were included. In addition to anatomic and visual results, associated complications were assessed. RESULTS: Anatomic success rate was 90.4% in 73 eyes. 64 eyes achieved attachment after oil injection combined vitrectomy and 8 of 64 eyes (12.5%) were redetached after oil removal. 37 eyes of the 64 eyes (57.8%) had an increase in visual acuity at least one Snellen line after oil removal. Glaucoma (21.9%), keratopathy (8.2%) and cataract (9.5%) were the complications. The mean duration of oil tamponade of detached group was 7.75 months and that of attached group was 7.14 months and there were no siginificant difference between two groups(P>0.05). CONCLUSIONS: The duration of the silicone oil tamponade had no siginificant effect on the redetachment rate. We recommend not to apply standard criteria for timing of silicone oil removal, but to decide individually, considering underlying disease and complications.