title: Refractive outcomes of combined phacovitrectomy and delayed cataract surgery in retinal detachment.
abstract: OBJECTIVE
  To compare the accuracy of refractive outcomes between combined pars plana vitrectomy (PPV) and cataract surgery and delayed cataract surgery after PPV in cases with rhegmatogenous retinal detachment (RD).
  
  
  METHODS
  Retrospective case series.
  
  
  METHODS
  Thirty-eight eyes underwent combined phacovitrectomy (combined group) and 25 eyes underwent delayed cataract surgery after PPV (delayed group).
  
  
  METHODS
  RD height was measured using optical coherence tomography. Refractive outcomes were evaluated using mean absolute error (MAE; the difference between final refractive error and target refractive error).
  
  
  RESULTS
  Combined group showed significant myopic shift (mean error; -0.40 ± 1.07 vs 0.07 ± 0.56 D, p = 0.028) and large MAE (0.81 ± 0.81 vs 0.48 ± 0.29 D, p = 0.028) compared with delayed group. Multiple logistic regression analysis revealed that only RD height was significantly associated with MAE greater than 2 D after combined surgery (in 100-µm unit, odds ratio 3.23, 95% CI 1.04-10.02, p = 0.042). RD height was also significantly correlated with the difference in axial length (AL) between 2 eyes of the patients (p = 0.006, r = 0.406) and the difference in AL measured at pre- versus post-RD repair in the delayed group (p < 0.001, r = 0.774).
  
  
  CONCLUSIONS
  Combined phacovitrectomy in patients with rhegmatogenous RD induced significant myopic shift because of underestimation of AL, especially in patients with high RD height. Thus, in cases with high temporal RD or large AL differences between eyes, either delayed cataract surgery or combined cataract surgery using the contralateral AL is recommended.
authors.affiliation: Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam; Department of Ophthalmology, Hallym University College of Medicine, Kangdong Sacred Heart Hospital, Seoul.
authors.forename: Yong-Kyu
authors.initials: YK
authors.lastname: Kim
authors.affiliation: Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam. Electronic address: sejoon1@snu.ac.kr.
authors.forename: Se Joon
authors.initials: SJ
authors.lastname: Woo
authors.affiliation: Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam.
authors.forename: Joon Young
authors.initials: JY
authors.lastname: Hyon
authors.affiliation: Department of Ophthalmology, Seoul National University College of Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, South Korea.
authors.forename: Jeeyun
authors.initials: J
authors.lastname: Ahn
authors.affiliation: Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam.
authors.forename: Kyu Hyung
authors.initials: KH
authors.lastname: Park
mesh_terms: D000368:Aged; D058452:Axial Length, Eye / Q000473:pathology; D001699:Biometry; D002386:Cataract / Q000150:complications; D058450:Endotamponade; D005260:Female; D005466:Fluorocarbons / Q000008:administration & dosage; D006801:Humans; D019654:Lens Implantation, Intraocular; D008297:Male; D008875:Middle Aged; D009216:Myopia / Q000209:etiology* / Q000503:physiopathology; D055095:Optics and Photonics; D018918:Phacoemulsification / Q000009:adverse effects* / Q000379:methods; D012029:Refraction, Ocular / Q000502:physiology; D012163:Retinal Detachment / Q000601:surgery*; D012189:Retrospective Studies; D013459:Sulfur Hexafluoride / Q000008:administration & dosage; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy / Q000009:adverse effects* / Q000379:methods
chemical_list: D005466:Fluorocarbons; C042852:perflutren; D013459:Sulfur Hexafluoride