Pars Plana Vitrectomy Combined With Phacoemulsification Versus Pars Plana Vitrectomy Only for Treatment of Phakic Rhegmatogenous Retinal Detachment: A Systematic Review and Meta-Analysis Publisher Pubmed



Mirshahi A¹ ; Khalilipour E¹ ; Faghihi H¹ ; Riaziesfahani H¹ ; Mirshahi R¹ ; Mehrjardi HZ¹ ; Najibzadeh E¹ ; Amini A² ; Nabavi A^{1, 3}
Source: International Ophthalmology Published:2023

Abstract

Purpose: To compare the visual, refractive, and anatomical outcomes and incidence of complications between combined pars plana vitrectomy and phacoemulsification (phacovitrectomy) versus pars plana vitrectomy (PPV-only) in phakic eyes with rhegmatogenous retinal detachment (RRD). Methods: Two independent reviewers searched MEDLINE, Cochrane Central, and Web of Science to identify relevant articles. Prospective or retrospective studies comparing PPV-only and phacovitrectomy for RRD were included. Recruited studies provided information about at least anatomical success or refractive outcomes. Meta-analysis was performed for single surgery success rate, final best-corrected visual acuity (BCVA), postoperative complications, mean predicted refractive error, and mean absolute predicted refractive error. Results: Seven studies (788 eyes) were selected, including two clinical trials and five retrospective comparative case series. The single surgery success rate was similar in PPV-only and phacovitrectomy groups (risk ratio [RR] = 1.02; 95% confidence interval [CI] 0.95–1.10; P = 0.57). Mean final BCVA was significantly better in the PPV-only group than the phacovitrectomy group (MD = 0.06; 95% CI 0.00–0.12; P = 0.04). The risk of epiretinal membrane formation was significantly higher in eyes that underwent phacovitrectomy than PPV-only (RR = 2.85; 0.95% CI 1.5–5.41; P = 0.001). Phacovitrectomy group showed a more myopic final mean predicted refractive error than PPV-only group (MD = −0.31; 95% CI −0.55–−0.07; P = 0.01). Conclusion: There was no significant difference between the two groups regarding the anatomical outcome. Slightly better visual and refractive results were observed in the PPV-only group. However, the results should be interpreted with caution as the majority of included studies were low-quality retrospective studies. © 2022, The Author(s), under exclusive licence to Springer Nature B.V.