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Abstract：
Pars plana vitrectomy is today a common first-line procedure for treatment of rhegmatogenous retinal detachment (RRD). Removal or preservation of the natural lens at the time of vitrectomy is associated with both advantages and disadvantages. The combination of cataract extraction (i.e., phacoemulsification) with pars plana vitrectomy (PPVc) enhances visualization of the peripheral retina and the surgical management of the vitreous base. However, PPVc prolongs the surgical time and is associated with iatrogenic loss of the accommodation function in younger patients, possible postoperative anisometropia, and unexpected refractive results. Performance of pars plana vitrectomy alone (PPVa) requires good technical skills to minimize the risk of lens damage, and quickens cataract development. We retrieved all recent papers that directly compared PPVc and PPVa using parameters that we consider essential when choosing between the two procedures (the success rate of anatomical RRD repair, postoperative refractive error, intra- and postoperative complications, and costs). PPVa and PPVc were generally comparable in terms of RRD anatomical repair. PPVc was associated with fewer intraoperative, but more postoperative, complications. Macula-off RRD PPVc treatment was often associated with undesirable myopic refractive error. PPVa followed by phacoemulsification was the most expensive procedure.
摘要：
平坦部玻璃体切除术是当今治疗孔源性视网膜脱离（RRD）的常见一线手术。在玻璃体切除术时去除或保留天然晶状体具有优点和缺点。白内障摘除术的组合(即超声乳化术）与平坦部玻璃体切除术（PPVc）增强了周围视网膜的可视化和玻璃体基底的手术管理。然而,PPVc延长了手术时间，并与年轻患者的医源性调节功能丧失有关，可能的术后屈光参差,和意想不到的屈光结果。单独进行平坦部玻璃体切除术（PPVa）需要良好的技术技能，以最大程度地减少晶状体损伤的风险，加快白内障的发展。我们检索了所有最近的论文，这些论文使用我们认为在两种程序之间进行选择时必不可少的参数（解剖RRD修复的成功率，术后屈光不正,术中和术后并发症，和成本）。PPVa和PPVc在RRD解剖修复方面通常具有可比性。PPVc与术中减少相关，但是术后更多，并发症。黄斑脱落的RRDPPVc治疗通常与不良的近视性屈光度有关。PPVa后再进行超声乳化是最昂贵的手术。
