Are all primary retinal detachments the same? Anatomic and functional differences between phakic and pseudophakic...

Area of Science:

• Ophthalmology
• Retinal Surgery
• Vitreoretinal Diseases

Background:

• Primary retinal detachment (RD) exhibits different pathogenic mechanisms based on lens status.
• Understanding these differences is crucial for effective treatment strategies.

Purpose of the Study:

• To investigate and compare the clinical characteristics and surgical outcomes of primary RD in pseudophakic (lens-absent) versus phakic (natural lens present) patients.

Main Methods:

• A retrospective analysis of 821 patients undergoing surgery for RD between 2012 and 2020.
• Patients were categorized into phakic RD (pRD) and pseudophakic RD (psRD) groups.
• Data collected included patient demographics, RD location, macular involvement, proliferative vitreoretinopathy, and reattachment rates.

Main Results:

• Pseudophakic patients were older (66.87 vs 58.24 years) and had a higher incidence of inferior and total RD.
• Proliferative vitreoretinopathy was significantly more frequent in the psRD group (7.88% vs 3.6%).
• Final anatomic reattachment rates were lower in pseudophakic patients (87.27%) compared to phakic patients (94.03%).

Conclusions:

• The distinct pathogenic mechanisms in pseudophakic retinal detachment are linked to poorer outcomes.
• Pseudophakic patients experience worse evolution characteristics and less favorable final anatomic and functional results.
• Lens status is a significant factor influencing the prognosis of primary retinal detachment.