Comparison of phacovitrectomy with pars plana vitrectomy alone in rhegmatogenous retinal detachment in presbyopic patients

Purpose: To compare the outcome of pars plana vitrectomy (PPV) alone and combined with phacoemulsification (phacovitrectomy) in eyes with rhegmatogenous retinal detachment (RRD) and any degree of accompanying lens opacity. Materials and Methods: Medical charts of patients who underwent PPV with or without phacoemulsification were retrospectively reviewed. Eyes were recruited in Group A in case phacoemulsification was not performed (n=66) and in Group B in case they underwent phacovitrectomy (n=36). Patients under the age of 40 were excluded. Demographic and baseline clinical features, anatomical and functional outcome as well as complications were compared. The primary outcome measure was anatomical and functional success following silicone oil removal. Results: The groups were similar in terms of number of retinal breaks, detached retinal quadrants in clock hours and macular status. Phacovitrectomy caused significantly higher fibrin reaction (p=0.007) and high intraocular pressure (p<0.005) that responded to medication in the postoperative course. In Group A, the lens opacity progressed in 47 eyes. Primary outcome measure was achieved in 38 patients in Group A and 19 patients in Group B (p=0.7). Conclusion: Simultaneous cataract surgery did not alter the outcome in eyes with RRD associated with any degree of cataract in presbyopic patients. The clinical outcome was similar with minor complications in both groups.