Combined phacoemulsification and sutureless vitrectomy for treatment of rhegmatogenous retinal detachment

Purpose: To report the success rate and possible complications of combined phacoemulsification and sutureless 23 gauge vitrectomy for treatment of rhegmatogenous retinal detachment (RRD). Patients and Methods: Thirty patients with RRD were included in the study. All patients were examined for the extent of detachment, number and location of retinal breaks, and degree of proliferative vitreoretinopathy (PVR). Combined phacoemulsification, intraocular lens implantation, 23 gauge vitrectomy, laser retinopexy, and 12% C3F8 injection were done for all patients. All eyes were followed for 3 months. The primary outcome measures were single operation success rate and change in best-corrected visual acuity (BCVA). Any intraoperative and postoperative complications were reported and analyzed. Results: The mean age of the patients was 43.9 ± 10.11 years; mean duration of detachment was 17.3 ± 5.53 days while mean preoperative BCVA measured by logarithm of the minimum angle of resolution (Log MAR) was 2.1 ± 0.71. Single operation success rate was achieved in 25 eyes (83.3%), 5 eyes (16.7%) showed failure of complete attachment after absorption of gas bubble. The mean postoperative BCVA was significantly better than the preoperative value (1.00, 1.1 after 6 weeks and 3 months, respectively, P < 0.01). The most common postoperative complications were reversible corneal edema that occurred in 11 eyes (36.6%), fibrinous uveitis in 8 eyes (26.6%) and posterior capsular opacification in 16 eyes (53.3%). Preoperatively, 1 eye (3.3%) had BCVA ≤1 (Log MAR) in comparison to 17 eyes (56.7%) and 18 eyes (60%) after 6 weeks and 3 months respectively. Conclusion: Combined phacoemulsification and sutureless vitrectomy with gas tamponade is safe and effective single surgical procedure for selected patients with RRD.