Clinical Evaluation Of Primary Posterior Capsulotomy In Vitrectomy Combined With Cataract Surgery Treating Rhegmatogenous Retinal Detachment With Cataract

Objective: To evaluate the outcome of primary posterior capsulotomy versus preservation of the posterior capsule in vitrectomy combined with phacoemulsification treating rhegmatogenous retinal detachment(RRD)with age-related cataract.Methods: A total of 58 eyes of 58 patients with RRD and age-related cataract that had undergone 23 G pars plana vitrectomy combined with phacoemulsification and silicon oil tamponade in People’s Hospital of Guangxi Zhuang Autonomous Region from September 2015 to August 2016 were retrospectively analysised.They were divided into two groups.28 eyes in group A were treated with primary posterior capsulotomy in vitrectomy and30 eyes in group B were treated with preservation and polishing of the posterior capsule in phacoemulsification.All eyes had silicone oil removal and simultaneous posterior chamber intraocular lens(PCIOL)placement during 3 to 4 months after retinal reattachment surgery.The basic data before surgery and the reattachment of retina,best corrected visual acuity(BCVA)and complication after surgery between two groups were compared.All eyes had at least 3 months of follow-up after silicone oil removal and simultaneous posterior chamber intraocular lens(PCIOL)placement.Results:(1)The rates of retinal reattachment were 89.28% in group A and 86.66% in group B in the first time of surgery.There was no difference in rates of retinal reattachment between two groups(P>0.05).(2)The difference of last follow-up log MAR BCVA compare with preoperative logMAR BCVAin two groups was statistically significant(P<0.05).Last follow-up logMAR BCVA was better to preoperative logMAR BCVA in two groups.The difference of postoperative logMAR BCVA between A groups and B groups was no statistically significant(P>0.05).The difference between the rates of visual acuity improved in two groups was no statistically significant(P>0.05).The difference between the rates of get rid of blindnessin in two groups was statistically significant(P<0.05),the rates of get rid of blindnessin in A groups was higher than B group.(3)The time of silicone oil removal and simultaneous PCIOL placement in A group was shorter than B group,the difference between them was statistically significant(P < 0.05).(4)The difference between the incidence rate of retinal redetachment,intraocular pressure elevation in the early,corneal edema,corneal epithelial defect,significant fibrous exudation in the anterior chamber,hyphema in two groups were no statistically significant(P>0.05).In addition,6 eyes of B groups developed posterior capsule opacification(PCO)during the follow-up period and BCVA improved after treated by Nd: YAG laser capsulotomy.Conclusions: Primary posterior capsulotomy in vitrectomy combined with phacoemulsification can not only guarantee the treatment effect of RRD with age-related cataract but also improve the rate of get rid of blindnessin,prevent PCO effectively and take less time to complete silicone oil removal and simultaneous PCIOL placement.