Yong-Kyu Kim1, Se Joon Woo2, Joon Young Hyon3, Jeeyun Ahn4, Kyu Hyung Park3. 1. Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam; Department of Ophthalmology, Hallym University College of Medicine, Kangdong Sacred Heart Hospital, Seoul. 2. Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam. Electronic address: sejoon1@snu.ac.kr. 3. Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam. 4. Department of Ophthalmology, Seoul National University College of Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, South Korea.
Abstract
OBJECTIVE: To compare the accuracy of refractive outcomes between combined pars plana vitrectomy (PPV) and cataract surgery and delayed cataract surgery after PPV in cases with rhegmatogenous retinal detachment (RD). DESIGN: Retrospective case series. PARTICIPANTS: Thirty-eight eyes underwent combined phacovitrectomy (combined group) and 25 eyes underwent delayed cataract surgery after PPV (delayed group). METHODS: RD height was measured using optical coherence tomography. Refractive outcomes were evaluated using mean absolute error (MAE; the difference between final refractive error and target refractive error). RESULTS: Combined group showed significant myopic shift (mean error; -0.40 ± 1.07 vs 0.07 ± 0.56 D, p = 0.028) and large MAE (0.81 ± 0.81 vs 0.48 ± 0.29 D, p = 0.028) compared with delayed group. Multiple logistic regression analysis revealed that only RD height was significantly associated with MAE greater than 2 D after combined surgery (in 100-µm unit, odds ratio 3.23, 95% CI 1.04-10.02, p = 0.042). RD height was also significantly correlated with the difference in axial length (AL) between 2 eyes of the patients (p = 0.006, r = 0.406) and the difference in AL measured at pre- versus post-RD repair in the delayed group (p < 0.001, r = 0.774). CONCLUSIONS: Combined phacovitrectomy in patients with rhegmatogenous RD induced significant myopic shift because of underestimation of AL, especially in patients with high RD height. Thus, in cases with high temporal RD or large AL differences between eyes, either delayed cataract surgery or combined cataract surgery using the contralateral AL is recommended.
OBJECTIVE: To compare the accuracy of refractive outcomes between combined pars plana vitrectomy (PPV) and cataract surgery and delayed cataract surgery after PPV in cases with rhegmatogenous retinal detachment (RD). DESIGN: Retrospective case series. PARTICIPANTS: Thirty-eight eyes underwent combined phacovitrectomy (combined group) and 25 eyes underwent delayed cataract surgery after PPV (delayed group). METHODS: RD height was measured using optical coherence tomography. Refractive outcomes were evaluated using mean absolute error (MAE; the difference between final refractive error and target refractive error). RESULTS: Combined group showed significant myopic shift (mean error; -0.40 ± 1.07 vs 0.07 ± 0.56 D, p = 0.028) and large MAE (0.81 ± 0.81 vs 0.48 ± 0.29 D, p = 0.028) compared with delayed group. Multiple logistic regression analysis revealed that only RD height was significantly associated with MAE greater than 2 D after combined surgery (in 100-µm unit, odds ratio 3.23, 95% CI 1.04-10.02, p = 0.042). RD height was also significantly correlated with the difference in axial length (AL) between 2 eyes of the patients (p = 0.006, r = 0.406) and the difference in AL measured at pre- versus post-RD repair in the delayed group (p < 0.001, r = 0.774). CONCLUSIONS: Combined phacovitrectomy in patients with rhegmatogenous RD induced significant myopic shift because of underestimation of AL, especially in patients with high RD height. Thus, in cases with high temporal RD or large AL differences between eyes, either delayed cataract surgery or combined cataract surgery using the contralateral AL is recommended.
Authors: Giuseppe Maria Albanese; Alberto Cerini; Giacomo Visioli; Marco Marenco; Magda Gharbiya Journal: BMC Ophthalmol Date: 2021-04-10 Impact factor: 2.209