Combined Phacoemulsification, Intraocular Lens Implantation, and Pars Plana Vitrectomy for Macular Sparing Rhegmatogenous Retinal Detachment Confirmed by Optical Coherence Tomogrphy: Visual Outcomes and Complications

Jung Yeul Kim, MD^1,2 Kyoung Nam Kim, MD¹, Ki Yup Nam, MD¹, Kyung Sup Shin MD¹, Jong Eun Lee MD¹

¹Department of Ophthalmology, Chungnam National University College of Medicine, Daejeon, Korea
¹Research Institute for Medical Science, Chungnam National University College of Medicine, Daejeon, Korea

Aims: To evaluate visual outcome of combined phacoemulsification, intraocular lens implantation, and pars plana vitrectomy for macular sparing rhegmatogenous retinal detachment with cataract.

Methods: In patients with rhegmatogenous retinal detachment with cataract, in whom the macular region of 6,000㎛ in diameter was not detached on the optical coherence tomography, a retrospective analysis was performed to examine the results of a combined surgery of vitrectomy with cataract extraction. Anatomy success rate, visual outcomes and postoperative complications which affects visual acuity were evaluated.

Results: In a total of 56 patients, with follow-up observation for more than 12 months postoperatively, the primary surgical success rate was 96.4%(54/56) and the final surgical success rate was 100%. The mean preoperative LogMAR visual acuity was 0.05 and decreased to 0.11 postoperatively (p<0.001). Of the 56 patients, 20 (35.7%) had a decreased visual acuity postoperatively, compared with the preoperative visual acuity (0.06, 0.27, respectively, p<0.001), which consisted of 6 cases of epiretinal membrane, 12 cases of posterior capsule opacity, and 2 cases of cystoids macular edema. In the remaining 36 patients, there was no significant difference in the visual acuity between preoperatively and postoperatively (0.04, 0.03, respectively, p=0.324).

Conclusions: In patients with macular sparing rhegmatogenous retinal detachment with cataract, whose visual prognosis might be excellent if retina was successfully reattached, a combined phacoemulsification, intraocular lens implantation, and pars plana vitrectomy could be an effective treatment regimen. However, The visual prognosis could be significantly affected by postoperative complications, such as an epiretinal membrane, posterior capsular opacity, and cystoid macular edema. Therefore, further studies are warranted to examine the methods to prevent these postoperative complications