Comparison between refractive outcomes between macula-on and macula-off retinal detachments after phaco-vitrectomy.

Purpose: To evaluate axial length (AL) measurements and refractive outcomes in vitrectomy combined with cataract operation for rhegmatogenous retinal detachment (RRD) with wholly detached macula.

Study Design: Retrospective, consecutive, comparative, clinical study.

Methods: We reviewed the data of patients treated by vitrectomy combined with cataract operation for RRD. The group "Attach" (n=31) consisted of eyes in which retina was not detached within 1.5 disc diameters from the foveal center, and the group "Detach" (n=33) consisted of eyes in which that area was detached entirely. Only those eyes inthe group "Detach", only the eyes (n=20) which AL were measured similar to those fellow eyes were compared to the group "Attach" (n=31). Refractive shift (RS) was defined as the average of the difference between postoperative spherical equivalent (SE) and predicted SE.

Results: AL was well measured by A-scan ultrasonography (A-scan) in all 31 eyes of the group "Attach" and their RS was ‒0.57 diopters (D). AL was measured by A-scan similar to the fellow eye in 20 of 33 eyes (60.6%) of the group "Detach", and the RS was ‒0.09 D. The AL difference as much as central subfield macular thickness (about 300um) can make this difference of RS (0.48 D, P=0.025) CONCLUSION: When AL can be measured by A-scan similar to its fellow eye in RRD with wholly detached macula, RS would be smaller than that of the wholly attached macula after phacovitrectomy. It assumed that AL was measured from the RPE under the detached macula in RRD with wholly detached macula.