SUMMARY
Background: We evaluated the anatomical and functional results of pars plana vitrectomy (PPV) for the treatment of complex rhegmatogenous retinal detachment (RRD).Methods: A retrospective analysis was performed on 88 eyes of 88 patients with complex RRD managed by PPV. The anatomical and functional outcomes were determined based on best-corrected visual acuity (BCVA) in the whole cohort of patients and in the groups classified based on crystalline lens status, macular status, and the presence of proliferative vitreoretinopathy (PVR) grade = C1. An optical coherence tomography (OCT) macular imaging was used to obtain images at the postoperative visit at least six months after PPV and determine the presence of discontinuity of ellipsoid zone (EZ), cystoid macular oedema (CME), epiretinal membrane (ERM), or macular hole (MH).Results: Anatomical outcome of primary PPV was 93.2%. Final retinal reattachment was achieved in all patients (88 eyes, 100%). BCVA improved from preoperative BCVA 1,7 ± 1,2 SD logMAR to postoperative BCVA 0,6 ± 0,7 SD logMAR (p=0,01). We showed worse anatomical outcomes in the group of patients with PVR grade = C1 (89.7%). Postoperative BCVA improved in all groups of patients, but after analysis according to the groups statistically significantly only in the phakic group (p=0.019), macula-off group (p=0.016), and in the group of patients with the presence of PVR grade = C1. Final BCVA was better in the pseudophakic group (0.75 ± 1.06), in the macula-on group (0.78 ± 1.30) and in patients without the presence of PVR (0.80 ± 1.15 logMAR). Postoperative OCT macular analysis showed discontinuity of EZ in 39%, CME in 15%, ERM in 2% and MH in 2%. Comparison of OCT variables according to the groups based on lens status, macular status, and presence of PVR grade = C1 showed the largest proportion of discontinuity of EZ in the group of patients with presence of PVR grade = C1 (58.6%).Conclusion: The anatomical and functional results of PPV in the treatment of complex RRD were highly successful. The overall functional outcome was better in pseudophakic patients, patients with macula-on detachment and patients without PVR. The largest proportion of patients with discontinuity of the EZ was in the group of patients with preoperative PVR.