title: Effect of lens status in the surgical success of 23-gauge primary vitrectomy for the management of rhegmatogenous retinal detachment: the Pan American Collaborative Retina Study (PACORES) group results.
abstract: OBJECTIVE
  To determine the effects of lens status on the success rate of primary pars plana vitrectomy (PPV) for rhegmatogenous retinal detachment using either perfluoropropane gas (C3F8) or silicone oil (SO) tamponade.
  
  
  METHODS
  A retrospective chart analysis was made of 97 eyes from 92 patients with rhegmatogenous retinal detachment with no proliferative vitreoretinopathy that were treated with primary 23-gauge PPV. Eyes included in this were phakic (n = 28), pseudophakic (n = 41), or phakic eyes subject to simultaneous phacoemulsification, intraocular lens implantation, and PPV during primary rhegmatogenous retinal detachment repair (n = 28). Tamponade at the end of PPV was with either C3F8 (n = 65) or SO (n = 32). Success was defined as retinal reattachment at 1 year follow-up after a single procedure in eyes submitted to C3F8 injection; in eyes treated with SO injection, the success rate was defined as retina reattached 1 year after oil removal. Statistical comparisons were made between groups using chi-square, Fisher's exact test, Kruskal-Wallis, Mann-Whitney, and multivariate analysis. All eyes were operated by 2 experienced retina surgeons and had a minimum follow-up of 12 months.
  
  
  RESULTS
  The vitreoretinal redetachment rate in eyes subjected to C3F8 tamponade was significantly higher (28.6%) for phakic eyes (P = 0.011) compared with pseudophakic or phakic eyes that underwent to phacoemulsification and intraocular lens implantation (4.5%). Eyes in which SO was used at the end of the surgical procedure demonstrated a similar trend of higher reoperation rates in phakic eyes (28.6%) compared with pseudophakic or phakic eyes (8%) subjected to phacoemulsification and intraocular lens implantation; however, no statistically significant difference was observed (P = 0.201). No statistically significant differences were found between groups in relation to the number of tears (P = 0.863) and their location (inferior: P = 0.189, superior: P = 0.708, nasal: P = 0.756, and temporal: P = 0.08).
  
  
  CONCLUSIONS
  The success rates of primary 23-gauge PPV with either C3F8 or SO tamponade in pseudophakic eyes with rhegmatogenous retinal detachment was higher than the same procedure performed in phakic eyes. Still, the retrospective and limited data presented is too preliminary to suggest or recommend that practitioners perform simultaneous combined cataract surgery with retinal detachment and requires further studies in a larger and prospective design to confirm these present findings.
authors.affiliation: *Department of Ophthalmology, Federal University of São Paulo, São Paulo, Brazil; †Brazilian Institute of Fight Against Blindness (INBRACE), Assis/Presidente Prudente, Brazil; ‡Retina Division, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland; §Vitreoretinal and Uveitis Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia; and ¶Retina and Vitreous Service, Instituto de Cirugia Ocular, San Jose, Costa Rica.
authors.forename: Rafael R
authors.initials: RR
authors.lastname: Caiado
authors.forename: Octaviano
authors.initials: O
authors.lastname: Magalhães
authors.forename: Emmerson
authors.initials: E
authors.lastname: Badaró
authors.forename: Andre
authors.initials: A
authors.lastname: Maia
authors.forename: Eduardo A
authors.initials: EA
authors.lastname: Novais
authors.forename: Francisco Rosa
authors.initials: FR
authors.lastname: Stefanini
authors.forename: Rodrigo Milan
authors.initials: RM
authors.lastname: Navarro
authors.forename: J Fernando
authors.initials: JF
authors.lastname: Arevalo
authors.forename: Lihteh
authors.initials: L
authors.lastname: Wu
authors.forename: Nilva
authors.initials: N
authors.lastname: Moraes
authors.forename: Michel Eid
authors.initials: ME
authors.lastname: Farah
authors.forename: Maurício
authors.initials: M
authors.lastname: Maia
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D058450:Endotamponade; D005260:Female; D005466:Fluorocarbons / Q000008:administration & dosage; D006801:Humans; D019654:Lens Implantation, Intraocular; D007908:Lens, Crystalline / Q000502:physiology*; D008297:Male; D008866:Microsurgery; D008875:Middle Aged; D018918:Phacoemulsification; D019591:Pseudophakia / Q000503:physiopathology*; D012163:Retinal Detachment / Q000503:physiopathology / Q000601:surgery*; D012189:Retrospective Studies; D012827:Silicone Oils / Q000008:administration & dosage; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy
chemical_list: D005466:Fluorocarbons; D012827:Silicone Oils; C042852:perflutren