Vitrectomy and silicone oil tamponade with and without phacoemulsification in the management of rhegmatogenous retinal detachment: A comparative study
| Autor: | Mohamed A. Abdelhakim, Youssef A H Helmy, Hany S. Hamza, Ayman M. Khattab, Ahmed A. Dahab |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Pars plana
Intraocular pressure medicine.medical_specialty phaco-vitrectomy genetic structures medicine.medical_treatment phaco-silicone removal Vitrectomy 030501 epidemiology 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Silicone silicone oil tamponade lcsh:Ophthalmology Ophthalmology medicine Dioptre pars plana vitrectomy business.industry rhegmatogenous retinal detachment Retinal detachment Phacoemulsification medicine.disease eye diseases medicine.anatomical_structure chemistry lcsh:RE1-994 030221 ophthalmology & optometry Tamponade 0305 other medical science business |
| Zdroj: | African Vision and Eye Health, Vol 79, Iss 1, Pp e1-e8 (2020) |
| ISSN: | 2410-1516 2413-3183 |
| Popis: | Background: A cataract inevitably develops after pars plana vitrectomy (PPV) with silicone tamponade. In patients with rhegmatogenous retinal detachment (RRD) of presbyopic age and without significant cataracts, phacoemulsification can be deferred to the time of silicone removal. Alternatively, it can be performed with PPV. Sparse evidence exists to choose one option over the other; this is usually left to the surgeon’s preference. Aim: To compare PPV with silicone tamponade alone, or combined with phacoemulsification for primary RRD, in patients without significant cataracts. Setting: This is a comparative prospective randomised interventional study that was conducted in Cairo University hospitals. Methods: The patients were randomised to two groups, each with 20 phakic patients presenting with RRD. Patients in Group A were randomised to PPV, followed by the phaco-silicone removal. Patients in Group B were randomised to phaco-vitrectomy, followed by silicone removal. Results: No statistically significant difference existed between the groups regarding the rate of intraoperative complications. Group B patients had a higher rate of early postoperative complications (intraocular pressure [IOP], corneal oedema and anterior chamber reaction). At final follow-up there was no statistically significant difference between the groups regarding the rate of retinal attachment or the best corrected visual acuity. Calculation of lens power was significantly more accurate in Group A, as evidenced by the difference in the mean spherical equivalent (Group A: –0.75 dioptre [D] vs Group B: –2.5 D, p = 0.031). Conclusion: This study suggests that no difference exists between the surgical options regarding anatomical success and intraoperative complications. Deferring phacoemulsification until the time of silicone oil removal offers an option with fewer early postoperative complications and more accurate lens power calculation. |
| Databáze: | OpenAIRE |
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