Changes in Postoperative Refractive Outcomes Following Combined Phacoemulsification and Pars Plana Vitrectomy for Rhegmatogenous Retinal Detachment

Abstract

To evaluate changes in postoperative refractive outcomes following combined phacoemulsification and pars plana vitrectomy for rhegmatogenous retinal detachment (RRD) compared with other retinal diseases. Retrospective observational case-control study. A total of 55 patients who had combined surgery between January 2007 and December 2012 were enrolled. The 25 patients who underwent combined surgery for RRD were included in the RRD group, and 30 patients who underwent combined surgery for other vitreoretinal pathology were included in the control group. Refractive axial length and intraocular pressure (IOP) measurements were performed, and the factors influencing the postoperative refractive outcomes were analyzed. The mean differences between the postoperative and predicted refractive outcomes in the RRD group and the control group were -0.43D±0.67 (P=.046) and -0.08D±0.53 (P=.767), respectively. The mean preoperative IOPs of the affected eye and the fellow eye in the RRD group were 11.44 mm Hg±3.15 and 13.16 mm Hg±2.73 (P=.045), but no differences were found in the affected eyes and fellow eyes of the control group. The differences were 14.20 mm Hg±2.95 and 14.17 mm Hg±3.50, respectively (P=.974). The mean postoperative IOPs in the affected eyes and the fellow eyes of the 2 groups were not significantly different. For all eyes, the refractive differences correlated with IOP changes in the RRD group. (r=.659, r2=.435, P<.001). The postoperative refractive outcomes in the RRD group shifted toward myopia by a mean of 0.35 diopters compared with the control group. Normalizing preoperative lowered IOP after combined surgery in RRD may be the key factor in understanding this myopic shift.