Abstract
Background: A study of the characteristics and the results obtained in 99 consecutive eyes operated on for rhegmatogenous retinal detachment associated with aphakia or pseudophakia in order to find the predictive factors of poor anatomical and functional results. Methods: The authors retrospectively reviewed the files of 99 consecutive cases of aphakic and pseudophakic retinal detachment operated on by the same surgeon between January 1992 through July 1993 with a minimum follow-up of 6 months. Multivariate and chi square analysis were carried out. Results: Of the pseudophakic eyes, 25 had an anterior chamber lens and 48 had a posterior chamber lens. The posterior capsule was disrupted using a Yag laser in 58% of those with an posterior chamber lens but only 14% of them developed detachment within 6 months. The rate of vitreous loss was 27% with 5% in case of intracapsular extraction, 31% in case of extracapsular extraction and 54% in case of phacoemulsification. PVR was present in 30% of the patients and 51% of detachments occurred more than 24 months as a mean after cataract surgery. The overall anatomic reattachment rate was 88% with no significant difference between the aphakic and the pseudophakic patients, either with an anterior chamber of posterior chamber lens. Visual results were significantly worse in the anterior chamber lens group and in the aphakic eyes (P < 0.02). Negative prognostic indicators for reattachment included poor preoperative vision, extension of the retinal detachment to the macula (P < 0.05) and grades B, C or D proliferative vitreoretinopathy (P < 0.01). In addition to the above factors, eyes with vitreous loss, anterior chamber lens, aphakia and a larger extent of the retinal detachment had a poor visual outcome. Conclusion: Most aphakic or pseudophakic retinal detachment can now be reattached with either scleral or vitreo retinal surgery. The main difficulties are the localisation of the breaks and the treatment of PVR. Indirect ophthalmoscopy associated with vitrectomy does well in cases of an opacified posterior capsule. In cases of severe PVR long term internal tamponade either with C3F8 or silicone oil improves anatomical results but the functional results remain inferior.
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References
Haimann MH, Burton C, Brown CK. Epidemiology of retinal detachment. Arch Ophthalmol 1982; 100: 289–92.
Yoshida A, Ogasawara H, Jalkh A, Sanders R, Mc Meel W, Schepens CL. Retinal detachment after cataract surgery. Predisposing factors. Ophthalmology 1992; 99: 453–9.
Stark W, Terry AC, Maumenee AR. In: Anterior Segment Surgery. Changing indications. Williams and Wilkins, Baltimore, pp. 69–87, 1987.
Stark WJ, Sommer A, Smith RE. Changing trends in intraocular lens implantation. Arch Ophthalmol 1989; 107: 1441–4.
Schepens CL. Retinal detachment and aphakia. Arch Ophthalmol 1951; 45: 1–17.
Schepens CL, Marden D. Data on the natural history of retinal detachment. I. Age and sex relationships. Arch Ophthalmol 1961; 66: 631–42.
Norton EWD. Retinal detachment in aphakia. Am J Ophthalmol 1964; 58: 111–24.
Ashrafzadeh MT, Schepens CL, Elzeneimy II. Aphakic and phakic retinal detachment. Preoperative findings. Arch Ophthalmol 1973; 89: 476–83.
Hawkins WR. Aphakic retinal detachment. Ophthalmic Surg 1975; 6: 66–74.
Jungschaffer OH. Retinal detachments after intraocular lens implants. Arch Ophthalmol 1977; 95: 1203–4.
Mertens DAE, Zivojnovic R, Baarsma GS. Retinal detachment and pseudophakos. Doc Ophthalmol 1979; 48: 267–71.
Wilkinson CP. Retinal detachments following intraocular lens implantation. Ophthalmology 1981; 88: 410–3.
Wilkinson CP. Pseudophakic retinal detachments. Retina 1985; 5: 1–4.
Ho PC, Tolentino FI. Pseudophakic retinal detachment: surgical success rate with various types of IOLs. Ophthalmology 1984; 91: 847–52.
Cousins S, Boniuk I, Okun E, Johnston GP, Arribas NP, Escoffery RE, Burgess DB, Grand MC, Olk RJ, Schoch LH. Pseudophakic retinal detachments in the presence of various IOL types. Ophthalmology 1986; 93: 1198–208.
Colliac Ph, Labetoulle M, Ameline B, Morel Ch, Haut J. Décollement de la rétine du pseudophaque. J Fr Ophtalmol 1992, 15 (1): 9–13.
Frau E, Sam H, Korobelnik JF, Chauvaud D. Retinal detachment after cataract surgery: retrospective study of 57 cases. Eur J Ophthalmol 1993; 3: 177–80.
Girard Ph, Karpouzas I. Pseudophakic retinal detachment: anatomic and visual results. Graefe's Arch Clin Exp Ophthalmol 1995; 233: 324–30.
Greven CM, Sanders RJ, Brown GC, Annesley WH, Sarin KK, Tasman W, Morgan TM. Pseudophakic retinal detachments. Anatomic and visual results. Ophthalmology 1992; 99: 257–62.
Yoshida A, Ogasawara H, Jalkh A, Sanders R, Mc Meel W, Schepens CL. Retinal detachment after cataract surgery. Surgical results. Ophthalmology 1992; 99: 460–5.
Mc Hugh D, Wong D, Chignell A, Leaver P, Coolling R. Pseudophakic retinal detachment. Graefe's Arch Clin Exp Ophthalmol 1991; 229: 521–5.
The Retina Society Terminology Committee. The classification of retinal detachment with proliferative vitreoretinopathy. Ophthalmology 1983; 90: 121–5.
Bonnet M. Microsurgery of retinal detachment. Springer-Verlag, Philadelphia, second edition, pp. 25–114, 1989.
Haut J, Arne JL, Rhairallah M. In: La prévention du décollement idiopathique de la rétine. Bulletin des Sociétés d'Ophtalmologie de France, rapport annuel, pp. 87–173, 1988.
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Berrod, J.P., Sautiere, B., Rozot, P. et al. Retinal detachment after cataract surgery. Int Ophthalmol 20, 301–308 (1997). https://doi.org/10.1007/BF00176882
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DOI: https://doi.org/10.1007/BF00176882