COMPLEX RETINAL DETACHMENT IN PHAKIC PATIENTS: Previtrectomy Phacoemulsification Versus Combined Phacovitrectomy.

Area of Science:

• Ophthalmology
• Retinal Surgery
• Cataract Surgery

Background:

• Complex rhegmatogenous retinal detachment often requires surgical intervention.
• Phakic patients with retinal detachment may necessitate cataract surgery.
• The timing of cataract surgery relative to pars plana vitrectomy is a key consideration.

Purpose of the Study:

• To compare preemptive cataract surgery (one week prior to vitrectomy) with combined phacovitrectomy.
• To evaluate the impact on postoperative anterior segment status.
• To assess final functional and anatomical outcomes in complex retinal detachment.

Main Methods:

• Retrospective review of 59 phakic patients with complex rhegmatogenous retinal detachment.
• Group 1: 29 patients underwent cataract surgery 7 days before vitrectomy.
• Group 2: 30 patients underwent combined phacovitrectomy.

Main Results:

• Preemptive cataract surgery (Group 1) demonstrated less posterior synechia postoperatively.
• No significant differences were observed in fibrin, posterior synechia rates, intraocular pressure, redetachment rates, or final visual acuity.
• Surgical time and tamponade types were similar between groups.

Conclusions:

• Preemptive cataract surgery is associated with reduced posterior synechia.
• Final functional and anatomical outcomes are comparable between preemptive cataract surgery and combined phacovitrectomy.
• Both surgical strategies are effective for complex retinal detachment in phakic eyes.