title: Combined cataract extraction and vitrectomy for macula-sparing retinal detachment: visual outcomes and complications.
abstract: OBJECTIVE
  To evaluate the visual outcome of combined phacoemulsification, intraocular lens implantation, and vitrectomy for macula-sparing rhegmatogenous retinal detachment.
  
  
  METHODS
  The results of combined vitrectomy with cataract extraction were retrospectively analyzed in patients with preexisting cataracts and new-onset rhegmatogenous retinal detachment. To qualify, patients must also have had macular sparing in a region 6,000 µm in diameter on optical coherence tomography. The anatomical success rate, visual outcomes, and postoperative complications relating to visual acuity were evaluated.
  
  
  RESULTS
  In 56 patients followed postoperatively for more than 12 months, the initial and final surgical success rate was 96.4% and 100%, respectively. The mean preoperative logarithm of the minimum angle of resolution visual acuity was 0.05 and decreased to 0.11 postoperatively (p < 0.001). Of the 56 patients, 20 (35.7%) had worse visual acuity postoperatively, compared with preoperatively (0.06 vs. 0.27, p < 0.001); these cases were comprised of six patients with epiretinal membranes, 12 patients with a posterior capsule opacity, and two patients with cystoid macular edema. In the remaining 36 patients, there were no significant differences in visual acuity preoperatively and postoperatively (0.04 vs. 0.03, p = 0.324).
  
  
  CONCLUSIONS
  In patients with cataracts who develop macula-sparing rhegmatogenous retinal detachment and whose visual prognosis is excellent assuming the retina can be reattached successfully, combined phacoemulsification, intraocular lens implantation, and vitrectomy might be an effective treatment. However, the visual prognosis is significantly affected by postoperative complications such as an epiretinal membranes, posterior capsule opacity, and cystoid macular edema. Therefore, further studies should examine methods to prevent these postoperative complications.
authors.affiliation: Department of Ophthalmology, Chungnam National University Hospital, Daejeon, Korea. ; Department of Ophthalmology, Chungnam National University College of Medicine, Daejeon, Korea.
authors.forename: Kyoung-Nam
authors.initials: KN
authors.lastname: Kim
authors.affiliation: Department of Ophthalmology, Chungnam National University Hospital, Daejeon, Korea.
authors.forename: Haeng-Jin
authors.initials: HJ
authors.lastname: Lee
authors.affiliation: Department of Ophthalmology, Chungnam National University Hospital, Daejeon, Korea.
authors.forename: Dong-Won
authors.initials: DW
authors.lastname: Heo
authors.affiliation: Department of Ophthalmology, Chungnam National University Hospital, Daejeon, Korea. ; Department of Ophthalmology, Chungnam National University College of Medicine, Daejeon, Korea.
authors.forename: Young-Joon
authors.initials: YJ
authors.lastname: Jo
authors.affiliation: Department of Ophthalmology, Chungnam National University Hospital, Daejeon, Korea. ; Department of Ophthalmology, Chungnam National University College of Medicine, Daejeon, Korea.
authors.forename: Jung-Yeul
authors.initials: JY
authors.lastname: Kim
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D019654:Lens Implantation, Intraocular / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification / Q000009:adverse effects; D011183:Postoperative Complications / Q000517:prevention & control; D012163:Retinal Detachment / Q000503:physiopathology / Q000601:surgery*; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D014792:Visual Acuity; D014821:Vitrectomy / Q000009:adverse effects
keywords: Cataract extraction; Optical coherence tomography; Pars plana vitrectomy; Retinal detachment