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Lookup NU author(s): Melissa Gough, Professor David SteelORCiD, Roxane Hillier
This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).
© 2026 American Academy of Ophthalmology, Inc.Objective To compare anatomic and visual outcomes of pars plana vitrectomy (PPV) versus phacovitrectomy for primary rhegmatogenous retinal detachment in phakic eyes using a multicenter database. Design Multicenter propensity score–matched cohort study. Participants Phakic eyes of patients aged >45 years undergoing primary rhegmatogenous retinal detachment repair were recorded in the British and Eire Association of Vitreoretinal Surgeons–European Society of Retina Specialists vitreoretinal database (2008–2024). Eyes with oil or perfluorocarbon liquid tamponade, secondary detachments, redo surgery, macular holes, buckles, relaxing retinectomy, or inadequate follow-up (<8 weeks) were excluded. The visual cohort excluded eyes with coexisting pathology affecting vision or missing postoperative visual acuity. Methods Generalized propensity score matching was performed. Primary anatomic success was assessed using weighted regression models. Follow-up logarithm of the minimum angle of resolution visual acuity was assessed using weighted linear regression. Sensitivity analyses adjusted for baseline cataract and restricted to eyes pseudophakic at outcome assessment. Main Outcome Measures Primary anatomic success (stable retinal reattachment ≥8 weeks after surgery without oil or perfluorocarbon liquid tamponade), follow-up logarithm of the minimum angle of resolution visual acuity and postoperative complications ≥8 weeks. Results A total of 6113 eyes were included in anatomic analyses (PPV 5647/6113 [92.4%]; phacovitrectomy 466/6113 [7.6%]) and 4726 eyes in visual analyses (PPV 4313/4726 [91.3%]; phacovitrectomy 413/4726 [8.7%]). Anatomic success exceeded 90% in both groups. In matched analyses, phacovitrectomy showed no significant difference in anatomic success compared with PPV (odds ratio, 1.20; 95% confidence interval, 0.92–1.60; P = 0.19; adjusted risk ratio, 1.02; 95% confidence interval, 0.97–1.07; P = 0.41). In the matched visual cohort, phacovitrectomy was associated with better visual acuity (–0.056 logarithm of the minimum angle of resolution; ≈3 ETDRS letters; 95% confidence interval, –0.091 to –0.009; P = 0.019). This attenuated after accounting for baseline cataract and restricting to pseudophakic eyes. Cystoid macular edema was more frequent after phacovitrectomy (8/413 (1.94%) vs. 15/4313 (0.35%); P < 0.001). Other complications were uncommon. Conclusions Phacovitrectomy achieved anatomic outcomes comparable to PPV for primary rhegmatogenous retinal detachment repair in phakic eyes. A small visual advantage was observed but attenuated in sensitivity analyses, suggesting the benefit is largely lens-related rather than a retinal treatment effect. Financial Disclosure(s) Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
Author(s): Gough M, Mujahid M, Yorston D, Lois N, Steel DH, Goldsmith C, Rowley S, Winder S, Le Mer Y, Smith J, Zambarakji H, Casswell AG, Sanchez-Chicharro DI, Babar A, Balaggan KS, Herbert EN, Cochrane T, Tanner V, Papastavrou V, Forsaa VA, Crama N, Hillier R, Ivanova T, Park JC, Jalil A, Spiteri-Cornish K, Membrey WL, Ellabban AA, Chandra A, Tarafdar S, Khan IJ, Jenkins H, Di Simplicio S, Mitrut I, Masri I, Ramkissoon Y, Gonzalez-Lopez JJ, Jmor F, Chua PY, Hussain RN, Tan SZ, Sandinha T, Pearce IA, Groenewald C, Heimann H, Khalil K, Casswell EJ, Dervenis N, Bloch E
Publication type: Article
Publication status: Published
Journal: Ophthalmology Retina
Year: 2026
Pages: epub ahead of print
Online publication date: 20/03/2026
Acceptance date: 16/03/2026
Date deposited: 09/06/2026
ISSN (print): 2468-7219
ISSN (electronic): 2468-6530
Publisher: Elsevier Inc.
URL: https://doi.org/10.1016/j.oret.2026.03.014
DOI: 10.1016/j.oret.2026.03.014
Data Access Statement: Data used in this study were obtained from BEAVRS-EURETINA vitreoretinal database. These data are not publicly available but may be available from the database custodians upon reasonable request and with appropriate approvals.
PubMed id: 41865838
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