Araştırma Makalesi
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Rhegmatogenous Retinal Detachment Repair: Surgical and Functional Results of Combined Phacovitrectomy versus Vitrectomy Alone

Yıl 2025, Cilt: 8 Sayı: 4, 424 - 429, 31.12.2025
https://doi.org/10.36516/jocass.1802389
https://izlik.org/JA85JD48YW

Öz

Purpose: To evaluate and compare the anatomical and functional outcomes of combined phacovitrectomy and pars plana vitrectomy (PPV) alone in the management of rhegmatogenous retinal detachment (RRD).
Methods: This retrospective study included patients who underwent surgery for primary RRD. The eyes were included in the phacovitrectomy and PPV-only groups basis of the initial lens status. Preoperative demographics, axial length, lens status, and intraocular pressure (IOP) were recorded. Surgical variables including tamponade use, adjuvant procedures, and perioperative complications were analyzed.
Results: A total of 69 eyes of 69 patients were analyzed. Single-surgery anatomical success was achieved in 87.9% of the eyes in the PPV-only group and 97.2% in the phacovitrectomy group (p = 0.186). Final reattachment was obtained in all eyes (100%). Recurrence occurred in 12.1% of the PPV-only cases versus 2.8% of the phacovitrectomy cases. Both groups demonstrated significant improvement in BCVA from baseline to the final visit (p < 0.001), with no significant intergroup difference (p = 0.342). Postoperative IOP elevation was observed in both groups but remained comparable (p = 0.562). The rates of epiretinal membrane formation, proliferative vitreoretinopathy, and inflammatory complications were similar between the two groups (p > 0.05 for all).
Conclusion: Both combined phacovitrectomy and PPV alone achieve high rates of retinal reattachment and significant functional recovery in primary RRD patients. Structured postoperative follow-up and careful surgical planning ensure predictable visual outcomes, with lens status serving as a key factor guiding individualized surgical strategies.

Kaynakça

  • 1.Tosi GM, Balestrazzi A, Baiocchi S, et al. Complex retinal detachment in phakic patients: previtrectomy phacoemulsification versus combined pha¬covitrectomy. Retina. 2017;37(4):630-636. [Crossref]
  • 2.Hillenmayer A, Wertheimer CM, Koenig SF, et al. Combined phacovitrec-tomy for retinal detachment and cataract-macular attachment and visual fix¬ation as predictors of postoperative refractive error. Ther Adv Ophthalmol. 2025;17:25158414251378632. [Crossref]
  • 3.Dahab AA, Helmy YA, Khattab AM, Abdelhakim MA, Hamza HS. Vitrectomy and silicone oil tamponade with and without phacoemulsification in the management of rhegmatogenous retinal detachment: A comparative study. African Vision and Eye Health. 2020;79(1):1-8. [Crossref]
  • 4.Demetriades AM, Gottsch JD, Thomsen R, et al. Combined phacoemulsifica¬tion, intraocular lens implantation, and vitrectomy for eyes with coexisting cataract and vitreoretinal pathology. Am J Ophthalmol. 2003;135(3):291-296. [Crossref]
  • 5.Chaudhry NA, Cohen KA, Flynn HW, Jr., Murray TG. Combined pars plana vitrectomy and lens management in complex vitreoretinal disease. Semin Ophthalmol. 2003;18(3):132-141. [Crossref]
  • 6.Kovács I, Ferencz M, Nemes J, Somfai G, Salacz G, Récsán Z. Intraocular lens power calculation for combined cataract surgery, vitrectomy and peeling of epiretinal membranes for macular oedema. Acta Ophthalmol Scand. 2007;85(1):88-91. [Crossref]
  • 7.Tranos PG, Allan B, Balidis M, et al. Comparison of postoperative refractive outcome in eyes undergoing combined phacovitrectomy vs cataract surgery following vitrectomy. Graefes Arch Clin Exp Ophthalmol. 2020;258(5):987-993. [Crossref]
  • 8.Frings A, Dulz S, Skevas C, et al. Postoperative refractive error after pha-covitrectomy for epiretinal membrane with and without macular oedema. Graefes Arch Clin Exp Ophthalmol. 2015;253(7):1097-1104. [Crossref]
  • 9.Suzuki Y, Sakuraba T, Mizutani H, Matsuhashi H, Nakazawa M. Postopera¬tive complications after simultaneous vitrectomy and cataract surgery. Oph¬thalmic Surg Lasers. 2001;32(5):391-396. [Crossref]
  • 10.Shiraki N, Wakabayashi T, Sakaguchi H, Nishida K. Optical biometry-based intraocular lens calculation and refractive outcomes after phacovitrectomy for rhegmatogenous retinal detachment and epiretinal membrane. Sci Rep. 2018;8(1):11319. [Crossref]
  • 11.Li W, Sun G, Wu R, Wang X, Xu M, Sun C. Longterm results after phacovitrectomy and foldable intraocular lens implantation. Acta Ophthalmol. 2009;87(8):896-900. [Crossref]
  • 12.Jun Z, Pavlovic S, Jacobi KW. Results of combined vitreoretinal surgery and phacoemulsification with intraocular lens implantation. Clin Exp Ophthalmol. 2001;29(5):307-311. [Crossref]
  • 13.Ahfat FG, Yuen CH, Groenewald CP. Phacoemulsification and intraocular lens implantation following pars plana vitrectomy: a prospective study. Eye (Lond). 2003;17(1):16-20. [Crossref]
  • 14.Shi L, Chang JS, Suh LH, Chang S. Differences in refractive outcomes between phacoemulsification for cataract alone and combined phacoemulsification and vitrectomy for epiretinal membrane. Retina. 2019;39(7):1410-1415. [Crossref]
  • 15.Vounotrypidis E, Haralanova V, Muth DR, et al. Accuracy of SS-OCT biometry compared with partial coherence interferometry biometry for combined phacovitrectomy with internal limiting membrane peeling. J Cataract Refract Surg. 2019;45(1):48-53. [Crossref]
  • 16.Findl O, Drexler W, Menapace R, Heinzl H, Hitzenberger CK, Fercher AF. Improved prediction of intraocular lens power using partial coherence interferometry. J Cataract Refract Surg. 2001;27(6):861-867. [Crossref]
  • 17.Wang JK, Hu CY, Chang SW. Intraocular lens power calculation using the IOLMaster and various formulas in eyes with long axial length. J Cataract Refract Surg. 2008;34(2):262-267. [Crossref]
  • 18.Rahman R, Kolb S, Bong CX, Stephenson J. Accuracy of user-adjusted axial length measurements with optical biometry in eyes having combined phacovitrectomy for macular-off rhegmatogenous retinal detachment. J Cataract Refract Surg. 2016;42(7):1009-1014. [Crossref]
  • 19.Falkner-Radler CI, Benesch T, Binder S. Accuracy of preoperative biometry in vitrectomy combined with cataract surgery for patients with epiretinal membranes and macular holes: results of a prospective controlled clinical trial. J Cataract Refract Surg. 2008;34(10):1754-1760. [Crossref]
  • 20.Pongsachareonnont P, Tangjanyatam S. Accuracy of axial length measurements obtained by optical biometry and acoustic biometry in rhegmatogenous retinal detachment: a prospective study. Clin Ophthalmol. 2018;12:973-980. [Crossref]

Regmatöjen Retina Dekolmanı Onarımı: Kombine Fakovitrektomi ile Sadece Vitrektominin Cerrahi ve Fonksiyonel Sonuçlarının Karşılaştırılması

Yıl 2025, Cilt: 8 Sayı: 4, 424 - 429, 31.12.2025
https://doi.org/10.36516/jocass.1802389
https://izlik.org/JA85JD48YW

Öz

Giriş:
Regmatöjen retina dekolmanı (RRD) tedavisinde kombine fakovitrektomi ile yalnızca pars plana vitrektominin (PPV) anatomik ve fonksiyonel sonuçlarını değerlendirmek ve karşılaştırmak.
Gereç ve Yöntemler:
Bu retrospektif çalışmaya, primer RRD nedeniyle cerrahi uygulanan hastalar dâhil edildi. Olgular, başlangıçtaki lens durumuna göre fakovitrektomi ve yalnızca PPV gruplarına ayrıldı. Ameliyat öncesi demografik veriler, aksiyel uzunluk, lens durumu ve göz içi basıncı (GİB) kaydedildi. Kullanılan tamponad türü, yardımcı cerrahi işlemler ve perioperatif komplikasyonlar gibi cerrahi değişkenler analiz edildi.
Sonuç:
Toplam 69 hastanın 69 gözü incelendi. Tek cerrahi ile anatomik başarı oranı, yalnızca PPV grubunda %87,9 ve fakovitrektomi grubunda %97,2 olarak saptandı (p = 0,186). Tüm olgularda (%100)nihai yeniden retinal yatışma sağlandı. Nüks, yalnızca PPV grubunda %12,1 oranında, fakovitrektomi grubunda ise %2,8 oranında görüldü. Her iki grupta da başlangıçtan son kontrole kadar düzeltilmiş en iyi görme keskinliğinde (EİGK) anlamlı artış izlendi (p < 0,001), ancak gruplar arasında anlamlı fark bulunmadı (p = 0,342). Ameliyat sonrası GİB artışı her iki grupta da gözlendi ancak istatistiksel olarak benzerdi (p = 0,562). Epiretinal membran oluşumu, proliferatif vitreoretinopati ve inflamatuvar komplikasyon oranları gruplar arasında benzerdi (tümünde p > 0,05).
Tartışma:
Hem kombine fakovitrektomi hem de yalnızca PPV, primer RRD olgularında yüksek retina yeniden yatışma oranı ve anlamlı fonksiyonel iyileşme sağlar. Düzenli postoperatif takip ve dikkatli cerrahi planlama, öngörülebilir görsel sonuçlar elde edilmesini destekler. Lens durumu ise bireyselleştirilmiş cerrahi stratejilerin belirlenmesinde kilit bir faktördür.

Kaynakça

  • 1.Tosi GM, Balestrazzi A, Baiocchi S, et al. Complex retinal detachment in phakic patients: previtrectomy phacoemulsification versus combined pha¬covitrectomy. Retina. 2017;37(4):630-636. [Crossref]
  • 2.Hillenmayer A, Wertheimer CM, Koenig SF, et al. Combined phacovitrec-tomy for retinal detachment and cataract-macular attachment and visual fix¬ation as predictors of postoperative refractive error. Ther Adv Ophthalmol. 2025;17:25158414251378632. [Crossref]
  • 3.Dahab AA, Helmy YA, Khattab AM, Abdelhakim MA, Hamza HS. Vitrectomy and silicone oil tamponade with and without phacoemulsification in the management of rhegmatogenous retinal detachment: A comparative study. African Vision and Eye Health. 2020;79(1):1-8. [Crossref]
  • 4.Demetriades AM, Gottsch JD, Thomsen R, et al. Combined phacoemulsifica¬tion, intraocular lens implantation, and vitrectomy for eyes with coexisting cataract and vitreoretinal pathology. Am J Ophthalmol. 2003;135(3):291-296. [Crossref]
  • 5.Chaudhry NA, Cohen KA, Flynn HW, Jr., Murray TG. Combined pars plana vitrectomy and lens management in complex vitreoretinal disease. Semin Ophthalmol. 2003;18(3):132-141. [Crossref]
  • 6.Kovács I, Ferencz M, Nemes J, Somfai G, Salacz G, Récsán Z. Intraocular lens power calculation for combined cataract surgery, vitrectomy and peeling of epiretinal membranes for macular oedema. Acta Ophthalmol Scand. 2007;85(1):88-91. [Crossref]
  • 7.Tranos PG, Allan B, Balidis M, et al. Comparison of postoperative refractive outcome in eyes undergoing combined phacovitrectomy vs cataract surgery following vitrectomy. Graefes Arch Clin Exp Ophthalmol. 2020;258(5):987-993. [Crossref]
  • 8.Frings A, Dulz S, Skevas C, et al. Postoperative refractive error after pha-covitrectomy for epiretinal membrane with and without macular oedema. Graefes Arch Clin Exp Ophthalmol. 2015;253(7):1097-1104. [Crossref]
  • 9.Suzuki Y, Sakuraba T, Mizutani H, Matsuhashi H, Nakazawa M. Postopera¬tive complications after simultaneous vitrectomy and cataract surgery. Oph¬thalmic Surg Lasers. 2001;32(5):391-396. [Crossref]
  • 10.Shiraki N, Wakabayashi T, Sakaguchi H, Nishida K. Optical biometry-based intraocular lens calculation and refractive outcomes after phacovitrectomy for rhegmatogenous retinal detachment and epiretinal membrane. Sci Rep. 2018;8(1):11319. [Crossref]
  • 11.Li W, Sun G, Wu R, Wang X, Xu M, Sun C. Longterm results after phacovitrectomy and foldable intraocular lens implantation. Acta Ophthalmol. 2009;87(8):896-900. [Crossref]
  • 12.Jun Z, Pavlovic S, Jacobi KW. Results of combined vitreoretinal surgery and phacoemulsification with intraocular lens implantation. Clin Exp Ophthalmol. 2001;29(5):307-311. [Crossref]
  • 13.Ahfat FG, Yuen CH, Groenewald CP. Phacoemulsification and intraocular lens implantation following pars plana vitrectomy: a prospective study. Eye (Lond). 2003;17(1):16-20. [Crossref]
  • 14.Shi L, Chang JS, Suh LH, Chang S. Differences in refractive outcomes between phacoemulsification for cataract alone and combined phacoemulsification and vitrectomy for epiretinal membrane. Retina. 2019;39(7):1410-1415. [Crossref]
  • 15.Vounotrypidis E, Haralanova V, Muth DR, et al. Accuracy of SS-OCT biometry compared with partial coherence interferometry biometry for combined phacovitrectomy with internal limiting membrane peeling. J Cataract Refract Surg. 2019;45(1):48-53. [Crossref]
  • 16.Findl O, Drexler W, Menapace R, Heinzl H, Hitzenberger CK, Fercher AF. Improved prediction of intraocular lens power using partial coherence interferometry. J Cataract Refract Surg. 2001;27(6):861-867. [Crossref]
  • 17.Wang JK, Hu CY, Chang SW. Intraocular lens power calculation using the IOLMaster and various formulas in eyes with long axial length. J Cataract Refract Surg. 2008;34(2):262-267. [Crossref]
  • 18.Rahman R, Kolb S, Bong CX, Stephenson J. Accuracy of user-adjusted axial length measurements with optical biometry in eyes having combined phacovitrectomy for macular-off rhegmatogenous retinal detachment. J Cataract Refract Surg. 2016;42(7):1009-1014. [Crossref]
  • 19.Falkner-Radler CI, Benesch T, Binder S. Accuracy of preoperative biometry in vitrectomy combined with cataract surgery for patients with epiretinal membranes and macular holes: results of a prospective controlled clinical trial. J Cataract Refract Surg. 2008;34(10):1754-1760. [Crossref]
  • 20.Pongsachareonnont P, Tangjanyatam S. Accuracy of axial length measurements obtained by optical biometry and acoustic biometry in rhegmatogenous retinal detachment: a prospective study. Clin Ophthalmol. 2018;12:973-980. [Crossref]
Toplam 20 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Cerrahi (Diğer)
Bölüm Araştırma Makalesi
Yazarlar

Seher Köksaldı 0000-0001-8235-4088

Şefik Can İpek 0000-0002-4651-8177

Mustafa Kayabaşı 0000-0003-2059-0696

Cem Yıldırım 0000-0002-5108-0069

Gönderilme Tarihi 13 Ekim 2025
Kabul Tarihi 21 Aralık 2025
Yayımlanma Tarihi 31 Aralık 2025
DOI https://doi.org/10.36516/jocass.1802389
IZ https://izlik.org/JA85JD48YW
Yayımlandığı Sayı Yıl 2025 Cilt: 8 Sayı: 4

Kaynak Göster

APA Köksaldı, S., İpek, Ş. C., Kayabaşı, M., & Yıldırım, C. (2025). Rhegmatogenous Retinal Detachment Repair: Surgical and Functional Results of Combined Phacovitrectomy versus Vitrectomy Alone. Journal of Cukurova Anesthesia and Surgical Sciences, 8(4), 424-429. https://doi.org/10.36516/jocass.1802389
https://dergipark.org.tr/tr/download/journal-file/11303