Mirshahi Ahmad, Khalilipour Elias, Faghihi Hooshang, Riazi-Esfahani Hamid, Mirshahi Romina, Mehrjardi Hadi Z, Najibzadeh Ehsan, Amini Abdulrahim, Nabavi Amin
Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Department of Ophthalmology, School of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
Int Ophthalmol. 2023 Feb;43(2):697-706. doi: 10.1007/s10792-022-02465-5. Epub 2022 Aug 19.
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).
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.
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).
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.
比较在有孔源性视网膜脱离（RRD）的有晶状体眼中，玻璃体切割联合超声乳化术（晶状体玻璃体切除术）与单纯玻璃体切割术（仅PPV）在视力、屈光和解剖学结果以及并发症发生率方面的差异。
两名独立评审员检索了MEDLINE、Cochrane中心和科学网以识别相关文章。纳入比较仅PPV和晶状体玻璃体切除术治疗RRD的前瞻性或回顾性研究。纳入的研究提供了至少关于解剖学成功或屈光结果的信息。对单次手术成功率、最终最佳矫正视力（BCVA）、术后并发症、平均预测屈光不正和平均绝对预测屈光不正进行荟萃分析。
选择了7项研究（788只眼），包括2项临床试验和5项回顾性比较病例系列。仅PPV组和晶状体玻璃体切除术组的单次手术成功率相似（风险比[RR]=1.02；95%置信区间[CI]0.95-1.10；P=0.57）。仅PPV组的平均最终BCVA显著优于晶状体玻璃体切除术组（MD=0.06；95%CI0.00-0.12；P=0.04）。接受晶状体玻璃体切除术的眼睛发生视网膜前膜形成的风险显著高于仅PPV组（RR=2.85；95%CI1.5-5.41；P=0.001）。晶状体玻璃体切除术组的最终平均预测屈光不正比仅PPV组更近视（MD=-0.31；95%CI-0.55--0.07；P=0.01）。
两组在解剖学结果方面无显著差异。仅PPV组在视力和屈光结果方面略好。然而，由于纳入的大多数研究是低质量的回顾性研究，因此对结果的解释应谨慎。
