Clinical- and Cost-effectiveness, Safety and Acceptability of Sequential Vitrectomy and Cataract Surgery vs Combined Phacovitrectomy for Rhegmatogenous Retinal Detachment: Randomised Equivalence Trial

What this Trial Is About

This research focuses on adults aged 50 and older with rhegmatogenous retinal detachment (RRD), a condition where the retina detaches from the back of the eye and can cause vision loss. The study compares two surgical approaches: performing vitrectomy alone versus combining vitrectomy with cataract surgery (phacoemulsification and intraocular lens implantation) at the same time. The goal is to find out which method leads to better vision outcomes, fewer surgeries, improved quality of life, patient satisfaction, and cost-effectiveness over one year. Participants will be randomly assigned to one of two groups. One group will have vitrectomy first and receive cataract surgery later if needed, while the other group will have both vitrectomy and cataract removal together in a single procedure called phacovitrectomy. The surgeries will be done according to standard care, with decisions on surgical tools and tamponade agents left to the surgeons. The study also includes an internal pilot phase to assess recruitment feasibility and collects detailed information to support future implementation of the preferred treatment approach. During the trial, participants will undergo vision assessments including best-corrected visual acuity at 52 weeks after surgery. Other evaluations will include anatomical success of retinal reattachment, complications during and after surgery, refractive error measurements, quality of life questionnaires, patient experience interviews, and health and social care usage. Data will be collected through clinical visits and questionnaires over the 52-week follow-up period to carefully monitor safety, effectiveness, and patient satisfaction.

Treatment of Retinal Detachment in People Who Have Not Had Cataract Surgery With Vitrectomy vs Vitrectomy and Cataract Removal