Baseline visual acuity Intact of lens capsule The location of intraocular lens Lower IOP (<10 mmHg) Macular sparing Extension of RD Identification of retinal break No. of retinal breaks Location of retinal break Type of operation Recurrence after primary surgery 0.254 0.796 0.852 0.491 0.602 0.733 0.002 0.468 0.192 0.796 0.060 Excluded variables: gender, age, laterality, presence of systemic complications, the time of retinal detachment evolution, the time between onset of retinal detachment and surgery, use of perfluorocarbone liquid, gas for intraocular tamponade, drainage for retinotomy, and type of implant for encircling bands and/or scleral sponges. IOP = intraocular pressure; RD = retinal detachment. *p-value, multivariate lineal regression analysis. Table 4. Characteristics of eyes with unidentified retinal breaks during the primary operation the normal range (2.50 ± 0.83 and 1.39 ± 1.12, respectively; p = 0.02). JW Lim, et al. Pseudophakic Retinal Detachment p-value* Rate of reoperation 0.384 0.540 0.340 0.452 0.425 0.080 0.002 0.263 0.406 0.364 0.000 0.058 0.163 0.153 0.020 0.194 0.433 0.020 0.563 0.492 0.154 0.048 Table 3. Multivariate regression analysis of factors for post-operative outcomes in patients with pseudophakia undergoing retinal detachment surgery Variables Rate of retinal reattachment Final visual acuity Variables Initial visual acuity* Macular status on:off Extension of retinal detachment <1Q:1-2Q:2-3Q:3-4Q Initial operation Vitrectomy combined scleral buckling Second operation Vitrectomy + gas tamponade Vitrectomy + silicone oil tamponade Retinal attachment after primary surgery Retinal attachment at last follow-up Final visual acuity Eyes with unidentified retinal breaks (n = 30) 1.25 ± 0.45 5:25 0:1:9:20 30 8 7 15 (50%) 20 (66.6%) 1.40 ± 1.32 Q = quadrant. *Logarithm of the minimum angle of resolution best-corrected visual acuity. identify retinal breaks, a lower IOP, and recurrence after the primary surgery (Table 3). The operative procedure, includ- ing the use of perfluorocarbon liquid, gas for intraocular tam- ponade, retinotomy for drainage, and type of implant used for encircling bands and/or scleral sponges, did not influence the final visual acuity. Eyes with unidentified retinal breaks presented larger ex- tension of the RD and a higher rate of pre-operative macula-off RD and the final visual acuity in the eyes with unidentified ret- inal breaks was worse than in the eyes with identified breaks (1.40 ± 1.32 and 0.73 ± 0.75, respectively; p = 0.02) (Table 4). In addition, a lower IOP was observed in 10 of the eyes (9.4%) pre-operatively and a lower IOP resulted in worse fi- nal visual acuity when compared to the eyes with an IOP in Discussion Surgical techniques in patients with pseudophakia after phacoemulsification have rapidly advanced in parallel with the development of better equipment. Previous studies in- volving patients with pseudophakic RDs have been reported before the era of phacoemulsification with micro-corneal in- cisions [5]. Thus, the reported surgical outcomes of patients with pseudophakic RDs may be improved upon. This retro- spective study involved 106 patients with a primary of idio- pathic pseudophakic rhegmatogenous RDs who had surgery by one surgeon over an 8-year period. Data relating to 21 pre-, intra-, and post-operative variables were studied. The final reattachment rate was 82%, which is slightly greater than what previous studies have reported [6-8]. Previous reports have identified the following negative prognostic fac- tors for reattachment after surgery: age >65 years; poor pre-operative vision; RD involving >3 quadrants; macula-off RDs; a lower IOP; inability to identify a retinal break; longer duration of symptoms; and grades C or D of proliferative vit- reoretinopathy [6-13]. In the current study, only an inability to identify a retinal break was significantly associated with lower reattachment success. Proliferative vitreoretinopathy grade C or D was not analyzed due to the exclusion criteria used in this study. A critical step in successful RD surgery is to locate and seal all of the causative retinal breaks. However, in pseudophakia, tiny breaks, poor mydriasis, cortical remnants, capsular opa- cification, glare or pitting from the intraocular lens implant, and corneal or vitreous opacities may make identification difficult, especially since anterior breaks commonly occur in 397