Pseudophakic retinal detachment

A total of 93 cases of pseudophakic retinal detachment are reported. The present study showed that vitreous loss had occurred during cataract surgery in 28% of eyes, indicating that anterior segment complications are an important contributory factor to aphakic retinal detachment in these cases. There was impairment of the retinal view in 46% of eyes, and in 22.5% no retinal breaks could be identified. The main factor responsible for poor visibility was inadequate pupillary dilatation, which was found particularly in association with the use of iris-supported lenses. Detachment of the macula was unexpectedly found to occur in as many as 88% of cases. Reattachment of the retina either by conventional detachment procedures or by pars plana vitrectomy was achieved in 76.3% of eyes. Complications directly attributable to the presence of an intraocular lens (such as dislocation or haemorrhage) are described. Failure of surgery was more likely to occur in eyes exhibiting a poor fundal view, in which the detection of retinal breaks was difficult. The best results were achieved in eyes in which posterior-chamber lenses had been implanted.Offprint requests to: A. Chiguell