Outcomes of Phacovitrectomy Performed Without Preoperative Steroid Therapy in Cases of Retinal and Choroidal Detachment

T Nkosi; M van der Merwe; L Ntsikelelo; J Botha; E Khumalo

Authors

T Nkosi Division of Neurology, Groote Schuur Hospital, University of Cape Town, Cape Town 7925, South Africa. Author
M van der Merwe Division of Neurology, Groote Schuur Hospital, University of Cape Town, Cape Town 7925, South Africa. Author
L Ntsikelelo Department of Microbiology, University of KwaZulu-Natal, Durban 4041, South Africa. Author
J Botha Department of Internal Medicine, Stellenbosch University, Stellenbosch 7600, South Africa Author
E Khumalo Division of Neurology, Groote Schuur Hospital, University of Cape Town, Cape Town 7925, South Africa Author

Keywords:

Retinal, Phacovitrectomy, Steroid Therapy , Choroidal Detachment

Abstract

Background: This study aimed to evaluate the anatomical and functional outcomes of combined phacoemulsification and microinvasive pars plana vitrectomy (phacovitrectomy) performed without preoperative steroid administration in patients with rhegmatogenous retinal detachment associated with choroidal detachment (RRD/CD).

Methods: Medical records of patients diagnosed with RRD/CD without a history of ocular trauma or prior intraocular surgery were retrospectively reviewed. All cases underwent phacovitrectomy with silicone oil (SO) tamponade, without the use of systemic or local corticosteroids before surgery. Patients were followed for a minimum of three months, with a mean follow-up duration of 10.3 ± 10.1 months.

Results: A total of 17 eyes from 17 patients (9 men and 8 women; mean age 60.4 ± 8.4 years) met the inclusion criteria. No eyes received intraocular lens implantation or additional scleral procedures during the initial operation. Preoperative ultrasonography revealed severe choroidal detachment in 10 eyes (58.8%), moderate in 2 eyes (11.8%), and mild in 5 eyes (29.4%). Primary retinal reattachment was achieved in 15 eyes (82.4%) after a single surgery. Of these, 14 eyes underwent silicone oil removal, 8 received intraocular lens implantation, 2 underwent epimacular membrane peeling, and 1 was re-tamponaded with silicone oil. Two patients developed recurrent detachment within one month due to proliferative changes and declined reoperation. Postoperatively, 15 eyes showed visual improvement, and 10 eyes achieved a final visual acuity of ≥0.1 (20/200). The mean intraocular pressure (IOP) at final follow-up was 15.7 ± 4.2 mmHg (range: 10–28 mmHg).

Conclusions: Combined phacovitrectomy without preoperative corticosteroid therapy provides favorable anatomic and visual outcomes in RRD/CD management. Omitting pre-surgical steroid use shortens the preoperative waiting period and minimizes potential complications associated with systemic or local corticosteroid administration.