Current epidemiological and surgical aspects of rhegmatogenous retinal detachment: a review

The review was performed across the Russian Science Citation Index and PubMed databases using the following keywords: "регматогенная отслойка сетчатки", "отслойка сетчатки", "витрэктомия", "факовитрэктомия", "rhegmatogenous retinal detachment", "retinal detachment", "vitrectomy", "phacovitrectomy". The prevalence of rhegmatogenous retinal detachment in different countries varies quite greatly from 2.6 to 28.3 cases per 100,000 population, with a clear trend toward an increase in its incidence over the last few decades, which has been demonstrated by multiple studies. This trend is mainly attributed to two factors—increased life expectancy and high incidence of myopia. The main epidemiological risk factors for rhegmatogenous retinal detachment are age, male sex, high meteorological instability, and myopic refraction. Currently, the treatment of rhegmatogenous retinal detachment usually includes vitrectomy, with phacovitrectomy or delayed cataract phacoemulsification being one of the leading subject of debate. Comparative studies of vitrectomy and phacovitrectomy for rhegmatogenous retinal detachment demonstrate a comparable (88.7%–100%) rate of achieving anatomically complete retinal re-attachment. Also, the pattern and incidence of complications are similar for both surgical procedures for rhegmatogenous retinal detachment. Calculating the power of an intraocular lens in post-phacovitrectomy patients may be quite challenging. The refractive outcome is considered less predictable in these patients, which often leads to postoperative myopic overcorrection. To date, there is no clear evidence suggesting that vitrectomy should be the first standalone procedure or combined phacovitrectomy may be the best strategy.