Clinical Efficacy and Safety of Phacovitrectomy in Surgical Treatment of Rhegmatogenous Retinal Detachment

Purpose: to study the clinical efficacy and safety of phacovitrectomy (PhEV) in the surgical treatment of rhegmatogenous retinal detachment (RRD). Materials and methods. We observed 146 patients (146 eyes) aged 34 to 77 years (mean age 56.4 ± 1.9 years). The inclusion criteria for patients in the study were: total RRD, complicated proliferative vitreoretinopathy (PVR) stages “B-C”, the presence of a native lens, no history of previous surgeries for RRD. All patients were divided into two groups equal in age, RRD localization and severity of PVR: the main group (MG, 74 patients, 74 eyes) — eyes that underwent PhEV; the control group (CG, 72 patients, 72 eyes) — who underwent only vitrectomy (VE). Comparative assessment of surgical safety was performed based on the incidence of intraoperative, early (up to 10 days) and late (1–3 months) postoperative complications. Comparative assessment of clinical efficacy of surgical intervention was performed based on the following parameters: anatomical retinal attachment, development of cystoid macular edema, and formation of epiretinal membrane. Results and discussion. The developed PhEV technique provides a higher level of safety and clinical efficacy of surgical treatment in patients with RRD, which is proven (compared to the group of patients who underwent only VE) by a decrease (on average, by 13.7, 4.1, 10.3 %) in the probability of intraoperative, early and late postoperative complications, as well as the incidence of cystoid macular edema and epiretinal membrane (p < 0.01). The main factor in intraoperative complications is a decrease (up to loss) in intraoperative visualization associated with the development of transient lens opacity. An increase in the incidence of cataract development in the CG during dynamic observation was noted from 16.7 % with an observation period of 10 days to 27.8 % with an observation period of 1–3 months. An almost identical and high (94.4–96.0 %) level of probability of anatomical reattachment of the retina was determined in patients of both groups. The higher level of safety and clinical effectiveness of PhEV (compared to VE) established in this work is explained by the significant advantages of the developed technique. Conclusion. The proposed PhEV technique can be recommended for the practice of surgical treatment of patients with RRD in accordance with the established indications.

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