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Pars plana vitrectomy combined with phacoemulsification versus pars plana vitrectomy only for treatment of phakic rhegmatogenous retinal detachment: a systematic review and meta-analysis

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Abstract

Purpose

To compare the visual, refractive, and anatomical outcomes and incidence of complications between combined pars plana vitrectomy and phacoemulsification (phacovitrectomy) versus pars plana vitrectomy (PPV-only) in phakic eyes with rhegmatogenous retinal detachment (RRD).

Methods

Two independent reviewers searched MEDLINE, Cochrane Central, and Web of Science to identify relevant articles. Prospective or retrospective studies comparing PPV-only and phacovitrectomy for RRD were included. Recruited studies provided information about at least anatomical success or refractive outcomes. Meta-analysis was performed for single surgery success rate, final best-corrected visual acuity (BCVA), postoperative complications, mean predicted refractive error, and mean absolute predicted refractive error.

Results

Seven studies (788 eyes) were selected, including two clinical trials and five retrospective comparative case series. The single surgery success rate was similar in PPV-only and phacovitrectomy groups (risk ratio [RR] = 1.02; 95% confidence interval [CI] 0.95–1.10; P = 0.57). Mean final BCVA was significantly better in the PPV-only group than the phacovitrectomy group (MD = 0.06; 95% CI 0.00–0.12; P = 0.04). The risk of epiretinal membrane formation was significantly higher in eyes that underwent phacovitrectomy than PPV-only (RR = 2.85; 0.95% CI 1.5–5.41; P = 0.001). Phacovitrectomy group showed a more myopic final mean predicted refractive error than PPV-only group (MD = −0.31; 95% CI −0.55–−0.07; P = 0.01).

Conclusion

There was no significant difference between the two groups regarding the anatomical outcome. Slightly better visual and refractive results were observed in the PPV-only group. However, the results should be interpreted with caution as the majority of included studies were low-quality retrospective studies.

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Authors and Affiliations

  1. Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran

    Ahmad Mirshahi, Elias Khalilipour, Hooshang Faghihi, Hamid Riazi-Esfahani, Romina Mirshahi, Hadi Z. Mehrjardi, Ehsan Najibzadeh & Amin Nabavi

  2. Department of Ophthalmology, School of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran

    Abdulrahim Amini

  3. Eye Research Center, Department of Ophthalmology, Amiralmomenin Hospital, Guilan University of Medical Sciences, 17th Shahrivar St, Rasht, Iran

    Amin Nabavi

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Mirshahi, A., Khalilipour, E., Faghihi, H. et al. Pars plana vitrectomy combined with phacoemulsification versus pars plana vitrectomy only for treatment of phakic rhegmatogenous retinal detachment: a systematic review and meta-analysis. Int Ophthalmol 43, 697–706 (2023). https://doi.org/10.1007/s10792-022-02465-5

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