Refractive Outcomes following Vitrectomy and Phacovitrectomy in Rhegmatogenous Retinal Detachment

Abstract

Background Cataracts are commonly seen during the diagnosis of rhegmatogenous retinal detachment (RRD) or occur following its surgical management. Refractive changes following combined phacoemulsification and vitrectomy (phacovitrectomy) can affect the quality of vision. This study aimed to evaluate the refractive changes following vitrectomy versus phacovitrectomy in patients with RRD. Methods A total of 96 patients who underwent retinal surgery for RRD in one eye, between August 2016 and January 2018, were enrolled and divided into three groups. In 18 eyes, 23-gauge transconjunctival sutureless vitrectomy (23G TSV) was performed (group A); 25G TSV was performed in 49 eyes (group B), and phacovitrectomy with 25G TSV was performed in 29 eyes (group C). Silicone oil was injected after the surgery in all three groups. Anterior and posterior corneal astigmatism, axial length (AL), and anterior chamber depth (ACD) were measured at baseline and postoperatively at 1 week, 1 month, and 3 months. Results Anterior and posterior corneal astigmatism did not change, and AL continued to increase for 3 months after surgery, whereas ACD decreased postoperatively but quickly returned to baseline in groups A and B. In group C, anterior and posterior corneal astigmatism, AL, and ACD increased postoperatively, and corneal astigmatism returned to baseline by 3 months, but AL and ACD continued to increase for 3 months. Conclusion Vitrectomy alone does not affect anterior or posterior corneal astigmatism. Following vitrectomy, the AL increases, while the ACD decreases transiently. When vitrectomy is combined with phacoemulsification for cataract removal, the anterior and posterior corneal astigmatism increases transiently, while AL and ACD are enlarged for several months following surgery.