PSEUDOPHAKIC RETINAL-DETACHMENT - ANATOMIC AND VISUAL RESULTS

Background: Our purpose was to report the anatomic and visual results of pseudophakic retinal detachment surgery in a large series of consec utive cases and to analyze the risk factors for anatomic and functiona l failure. Methods: This retrospective study covered 290 primary cases of idiopathic rhegmatogenous retinal detachment operated on by the sa me surgeon during an 8-year period. Data relating to 26 pre-, per-, an d postoperative variables were studied. For the statistical analyses w e used both Chi-square and stepwise logistic regression tests. Results : Vitreous loss occurred in 56 cases (19.3%), and the retina detached more than 2 years after lens extraction in 108 cases (37.2%). Breaks c ould be identified in 249 cases (85.8%), and the macula was involved i n 235 (81%). The overall reattachment rate was 85.2% (247/290), and a postoperative visual acuity of 0.5 D or more was attained in 49.6% of cases (144/290). We found no difference between phakoemulsification, e xtracapsular, intracapsular techniques or between anterior chamber, po sterior chamber, iris-fixated lenses as regards anatomic and functiona l outcomes. Proliferative vitreoretinopathy (PVR) and photoreceptor dy sfunction were the main causes of anatomic and functional failure resp ectively. We identified extensive detachment, preoperative choroidal d etachment, intraoperative hemorrhage and surgery for PVR as predictors of anatomic failure, while preoperative inflammation, preoperative PV R of grade B or worse, and surgery for PVR were predictors of function al failure. Conclusion: In this series, anatomic and visual results of reattachment surgery were much more affected by detachment features a nd by PVR than by the techniques and complications of cataract surgery .