PURPOSE: To evaluate the incidence and direction of postoperative retinal displacement after pars plana vitrectomy(PPV) for macula-off rhegmatogenous retinal detachment(RRD) developing after phacoemulsification, and to assess associations with pre-phacoemulsification axial length(AL) and postoperative metamorphopsia. METHODS: This retrospective study included 32 eyes with post-phacoemulsification, macula-off pseudophakic RRD treated with primary 25-gauge PPV using either 14% perfluoropropane(C₃F₈) gas or 5,000-cSt silicone oil(SiO) tamponade.Tamponade was preferentially selected by break location: superior breaks received C₃F₈, whereas inferior breaks(4 to 8 o'clock) received SiO.Perfluorocarbon liquid-assisted drainage through the break was performed without retinotomy or internal limiting membrane peeling.Retinal displacement was evaluated on fundus autofluorescence obtained after tamponade clearance, specifically 1 month after SiO removal and 1 month after complete C₃F₈ gas resorption and was defined by retinal vessel printings ≥ 2 optic disc diameters.Metamorphopsia was quantified using M-CHARTS at months 1, 3, and 6. RESULTS: SiO was used in 19 eyes(59.4%) and C₃F₈ in 13(40.6%).Retinal displacement occurred in 7/19 eyes(36.8%) in the SiO group and 8/13(61.5%) in the C₃F₈ group(p = 0.169).Displacement direction differed significantly: SiO showed superior(21.1%) and inferior(15.8%) displacement, whereas C₃F₈ showed exclusively inferior displacement (61.5%)(p = 0.016).AL did not differ by displacement status within either group(SiO p = 0.922; C₃F₈ p = 0.428) and showed no correlation with M-CHARTS change scores at any interval (all p ≥ 0.283).M-CHARTS scores (vertical, horizontal, and mean) were comparable between groups at months 1, 3, and 6 (all p > 0.05). CONCLUSION: In macula-off RRD developing after phacoemulsification, postoperative retinal displacement was common and showed tamponade-specific directionality, uniformly inferior with C₃F₈ and more heterogeneous with SiO.Within this cohort's AL range, AL was not associated with displacement or metamorphopsia. CLINICAL TRIAL REGISTRATION: Not applicable.
Guler et al. (Thu,) studied this question.