Purpose: Extracapsular cataract extraction and intraocular lens implantation have become a widespread surgical method in Hungary during the last 10 years. Consecutive pseudophakic retinal detachment cases show an increasing trend.
Method: 27 patients with pseudophakic retinal detachment were observed during a 3-year period. Careful fundus examination was carried out with indirect ophthalmoscopy, slit-lamp biomicroscopy and ultrasonography. The surgical method of choice was a standard operation (scleral buckling, encircling bend, cryopexy and laser coagulation) as first approach, or, in cases of PVR pars plana vitrectomy with fluid-gas exchange or silicon oil implantation. When reoperation was required, standard methods and/or pars plana vitrectomy with silicon oil implantation was applied.
Results: 17 out of 27 retinas reattached. Reoperation was necessary in 10 cases. Standard method failed in 8 out of 17 cases. Vitrectomy was successful in nine out of 17 cases.
Conclusion: Pseudophakic retinal detachment often produces diagnostic difficulties: smell, undilatable pupils, capsular fibrosis, slightly decentred intraocular lens inhibit detection of tears. In these cases vitrectomy is recommended as first surgical approach. In severe cases removal of the intraocular lenses should be considered.