Preprint Review Version 1 Preserved in Portico This version is not peer-reviewed

Pars Plana Vitrectomy Alone or Combined with Phacoemulsification to Treat Rhegmatogenous Retinal Detachment: A Systematic Review of the Recent Literature

Carlo Bellucci
ORCID logo ,
Alessandra Romano
,
Francesca Ramanzini
,
Salvatore Antonio Tedesco
,
Stefano Gandolfi
,
Paolo Mora
* ORCID logo
Version 1 : Received: 14 June 2023 / Approved: 15 June 2023 / Online: 15 June 2023 (07:57:05 CEST)

A peer-reviewed article of this Preprint also exists.

Bellucci, C.; Romano, A.; Ramanzini, F.; Tedesco, S.A.; Gandolfi, S.; Mora, P. Pars Plana Vitrectomy Alone or Combined with Phacoemulsification to Treat Rhegmatogenous Retinal Detachment: A Systematic Review of the Recent Literature. J. Clin. Med. 2023, 12, 5021. Bellucci, C.; Romano, A.; Ramanzini, F.; Tedesco, S.A.; Gandolfi, S.; Mora, P. Pars Plana Vitrectomy Alone or Combined with Phacoemulsification to Treat Rhegmatogenous Retinal Detachment: A Systematic Review of the Recent Literature. J. Clin. Med. 2023, 12, 5021.

Abstract

Pars plana vitrectomy is today a common first-line procedure for treatment of rhegma-togenous retinal detachment (RRD). Removal or preservation of the natural lens at the time of vitrectomy is associated with both advantages and disadvantages. The combi-nation of cataract extraction (i.e., phacoemulsification) with pars plana vitrectomy (PPVc) enhances visualization of the peripheral retina and the surgical management of the vitreous base. However, PPVc prolongs the surgical time and is associated with iatrogenic loss of the accommodation function in younger patients, possible postoperative aniso-metropia, and unexpected refractive results. Performance of pars plana vitrectomy alone (PPVa) requires good technical skills to minimize the risk of lens damage, and quickens cataract development. We retrieved all recent papers that directly compared PPVc and PPVa using parameters that we consider essential when choosing between the two procedures (the success rate of anatomical RRD repair, postoperative refractive error, intra and postoperative complications, and costs). PPVa and PPVc were generally comparable in terms of RRD anatomical repair. PPVc was associated with fewer intraoperative, but more postoperative, complications. Macula-off RRD PPVc treatment was often associated with undesirable myopic refractive error. PPVa followed by phacoemulsification was the most expensive procedure.

Keywords

Pars plana vitrectomy; Rhegmatogenous retinal detachment; Cataract surgery; Phacovitrectomy; Lens-sparing vitrectomy

Subject

Medicine and Pharmacology, Ophthalmology

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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