Researchers recently found that presenting features differed significantly between pseudophakic and phakic rhegmatogenous retinal detachments (RD), with greater occurrence of inferior retinal breaks and inferior retinal involvement in particular.

This retrospective, comparative clinical study evaluated 4,231 eyes (1,332 pseudophakic and 3,019 phakic) of patients older than 50 who had undergone RD repair.

The team observed significant differences in pseudophakic RD compared with phakic patients, including older age, higher prevalence of male gender, foveal detachment, grade C proliferative vitreoretinopathy (PVR), inferior retinal breaks, inferior retinal involvement and greater RD extent.

Despite the more advanced features of pseudophakic RD, they noted that pseudophakia was a positive factor for visual outcome. Contralateral RD was more frequent in pseudophakic than phakic RD.

Within phakic RD, the investigators also discovered that those with cataract exhibited several similarities with pseudophakic RD, including older age, more frequent foveal detachment, PVR and greater RD extent.

The results suggest there may be a genetic component to pseudophakic RD, in addition to the cataract surgery, the researchers noted in the study.

Ferrara M, Mehta A, Qureshi H, et al. Phenotype and outcomes of phakic versus pseudophakic primary rhegmatogenous retinal detachments: cataract or cataract surgery related? Am J Ophthalmol. September 25, 2020. [Epub ahead of print].