Prognosis of pseudophakic retinal detachment

Abstract

In their retrospective review of 400 patients, Christensen and Villumsen1 conclude that the surgical outcomes of pseudophakic and phakic retinal detachments are comparable. This finding agrees with that in another retrospective review of 243 consecutive phakic and pseudophakic individuals with primary retinal detachment who had had surgical repairs.2 However, if we take a closer look at the data presented by Christensen and Villumsen, a major incongruity with the previous studies is encountered. As pointed out by Halberstadt et al.,3 the size of the retinal detachment significantly influences the surgical outcome in pseudophakic and phakic eyes with retinal detachment. In retinal detachments of more than 3 quadrants, the detachment size substantially affects the postoperative results in pseudophakic eyes more than it does phakic eyes.3 According to Table 3 in the article by Christensen and Villumsen, large detachment of 3 or more quadrants occurred in 69 (24.6%) phakic and 38 (31.7%) pseudophakic individuals. No significant difference in the overall extent of detachments between groups was reported. Therefore, it may be inferred that the pseudophakic group should have done worse in terms of surgical outcome under the influence of a similar proportion of large retinal detachment compared with the phakic group. Other unmentioned confounding factors may have been operating and offsetting the influence of the large detachment in pseudophakic patients. The authors' further enlightenment of this issue would be much appreciated.