Purpose: To compare refractive outcomes and accuracy of modern optical biometry, swept-source optical coherence tomography, ultrasound biometry, and effect of the macula status in rhegmatogenous retinal detachment managed with either combined phacovitrectomy or sequential vitrectomy and cataract surgery compared with a control, phacoemulsification alone.Methods: Retrospective, comparative, consecutive study of 154 eyes; Group 1 underwent phacovitrectomy (n: 70), Group 2 underwent vitrectomy with subsequent cataract surgery (n: 41), and Group 3 underwent cataract surgery alone (n: 43).Results: No difference in the mean absolute error was found between Group 2 (0.41 ± 0.56) and Group 3 (0.41 ± 0.29); both were superior to Group 1 (0.74 ± 0.57). Between Group 1 and Group 2, no statistically significant difference in the mean absolute error was found between macula-on subgroups (P = 0.057), but this was statistically significant between macula-off subgroups (P = 0.009). Subgroup analysis by biometry showed that the difference in the mean absolute error between macula-off optical biometry Group 1 and Group 2 against our control, Group 3, were not significant (P = 0.078 and P = 0.119, respectively); the mean absolute error was significantly different when considering macula-off ultrasound biometry cases (P , 0.001 and P = 0.038, respectively).Conclusion: All three groups had comparable refractive outcomes when using optical biometry. However, phacovitrectomy macula-off cases had inferior refractive outcomes when the ultrasound biometry had to be used. In macula-off rhegmatogenous retinal detachment, when optical biometry is not reliable, it is preferable to perform sequential surgery rather than phacovitrectomy.
Purpose-To describe a surgical technique in which a suture, instead of forceps, is used to improve access for the introduction of scissors and more easily achieve an appropriately-sized punctoplasty.Materials and Methods-In this technique, a new modification of the 2-snip punctoplasty, a 6-0 polyglactin 910 suture is passed through the posterior wall of the punctum to apply traction. A video of the technique is provided.Results-This technique improves the surgical field of view and eases access for introduction of Vannas scissors into the punctum to perform the punctoplasty.Conclusions-This simple and practical modification of the 2-snip punctoplasty improves instrument access so that an appropriately-sized punctoplasty can be performed with ease.
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