How do you decide between a combined phacovitrectomy approach versus a staged procedure for patients with a retinal detachment and dense cataract?  

A primary buckle might be a consideration here to avoid the issue of the cataract altogether. But if planning to add a buckle (with vitrectomy) during these cases, it is impossible to preoperatively perform lens measurements (i.e., axial length), which would be a relative contraindication to perform...

In a patient with a dense cataract and non-PVD-related RD (an uncommon scenario since a dense cataract is typically seen in older patients, and RDs are usually PVD-related in that age group), staging the RD repair—buckle first, followed by phaco once the retina is attached—is an option. ...