Molecular And Clinical Predictors Of The Effectiveness Of Primary Vitrectomy And Extracleral Filling In Phakic Patients With Regmatogenic Retinal Detachment

Abstract

Goal. To evaluate the clinical outcomes and complications of primary vitrectomy compared with extracleral filling in phakic patients with regmatogenic retinal detachment, taking into account the localization and number of ruptures. Materials and methods. A prospective study involving twenty-three patients was conducted at the Multidisciplinary Hospital No. 2 in St. Petersburg from October 2024 to May 2025. The patients were randomly divided into two groups: the primary vitrectomy group (twelve patients) and the scleral filling group (eleven patients). All operations were performed according to modern standards of surgical treatment, followed by follow-up for nine months. Results. The primary indicator of anatomical retinal fit was 83.3 percent in the vitrectomy group and 81.8 percent in the filling group, while the differences did not reach statistical significance. After nine months, the final retinal fit was achieved in all cases in both groups. Visual acuity improved significantly in both groups, but faster recovery was noted in patients after scleral filling. At the same time, cataract development was more often detected in patients after vitrectomy, whereas cases of residual subretinal fluid and infection in the buckle area were observed after filling. Conclusions. Both methods provide high efficiency in the treatment of regmatogenic retinal detachment in phakic patients. The choice of surgical tactics should take into account the location and number of ruptures, which increases the likelihood of a successful outcome and minimizes complications. The significance of the study lies in the fact that it helps doctors to choose a reasoned treatment method, taking into account the risks of complications and the features of the clinical picture.