Rhegmatogenous Retinal Detachment Repair: Surgical and Functional Results of Combined Phacovitrectomy versus Vitrectomy Alone

Purpose: To evaluate and compare the anatomical and functional outcomes of combined phacovitrectomy and pars plana vitrectomy (PPV) alone in the management of rhegmatogenous retinal detachment (RRD). Methods: This retrospective study included patients who underwent surgery for primary RRD. The eyes were included in the phacovitrectomy and PPV-only groups basis of the initial lens status. Preoperative demographics, axial length, lens status, and intraocular pressure (IOP) were recorded. Surgical variables including tamponade use, adjuvant procedures, and perioperative complications were analyzed. Results: A total of 69 eyes of 69 patients were analyzed. Single-surgery anatomical success was achieved in 87.9% of the eyes in the PPV-only group and 97.2% in the phacovitrectomy group (p = 0.186). Final reattachment was obtained in all eyes (100%). Recurrence occurred in 12.1% of the PPV-only cases versus 2.8% of the phacovitrectomy cases. Both groups demonstrated significant improvement in BCVA from baseline to the final visit (p < 0.001), with no significant intergroup difference (p = 0.342). Postoperative IOP elevation was observed in both groups but remained comparable (p = 0.562). The rates of epiretinal membrane formation, proliferative vitreoretinopathy, and inflammatory complications were similar between the two groups (p > 0.05 for all). Conclusion: Both combined phacovitrectomy and PPV alone achieve high rates of retinal reattachment and significant functional recovery in primary RRD patients. Structured postoperative follow-up and careful surgical planning ensure predictable visual outcomes, with lens status serving as a key factor guiding individualized surgical strategies.