Prognosis of pseudophakic retinal detachment

To compare preoperative and postoperative findings in phakic and pseudophakic patients operated on for rhegmatogenous retinal detachment (RD).

Herlev University Hospital, Copenhagen, Denmark.

This retrospective review comprised 120 pseudophakic patients and 280 phakic patients who had RD surgery during a 4-year period. An identical scleral buckling procedure was used for primary surgery in both groups. Cataract surgery had been performed using extracapsular cataract extraction (ECCE) in most eyes; phacoemulsification was used in 67.5% of the pseudophakic eyes. The mean follow-up was 13.5 months.

Pseudophakic patients with RDs presented with significantly worse preoperative visual acuity than phakic patients due to a higher frequency of total RDs and macula-off RDs. Retinal breaks were found significantly less frequently and reoperations were performed with a higher frequency in pseudophakic patients than in phakic patients. At 6 months, no differences between pseudophakic and phakic patients were found. The overall anatomic reattachment rate was 94% and 96% in the 2 groups, and the visual outcome was also identical, with a visual acuity better than 0.4 in about 60% of patients.

Pseudophakic patients presented with more extended RDs and with the macula detached more frequently. Retinal breaks were found less frequently. Despite these findings, the anatomic and visual prognosis of pseudophakic detachments was identical to that of phakic detachments.