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

Abstract

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.

Keywords

• Cataract surgery
• pars plana vitrectomy
• phacovitrectomy
• rhegmatogenous retinal detachment

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

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.

Anahtar Kelimeler

• Katarakt cerrahisi
• Pars plana vitrektomi
• Fakovitrektomi
• Regmatöjen retina dekolmanı

Kaynakça

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