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To date, despite improvements in technology and surgical methods of treating retinal detachment, the rate of vision loss remains at a high level. Literature data indicate that visual acuity reaches 20/40 in 42% of eyes operated on for retinal detachment, and only in 28% of eyes with macular detachment. The emergence of new highly informative diagnostic methods made it possible to study the structure of the retina, especially the macula, to a greater extent, and to determine the factors that determine the decline of visual functions. The presence of a cataract or a high risk of its development after vitrectomy was the reason for the development of a combined lens and vitreous removal procedure. A significant advantage of the combined operation is the possibility of full access to the front part of the vitreous body and the periphery of the retina. In the presence of a natural lens, it is impossible to completely remove the vitreous body. Residual vitreous often leads to the development of anterior proliferative vitreoretinopathy, the formation of peripheral tears and retinal detachment. 64 patients (64 eyes) with rhegmatogenous retinal detachment in combination with age-related cataracts were under observation, who were subjected to СSV with tamponade of the vitreous cavity with silicone oil, endolaser coagulation of the retina and Phaco with IOL implantation. Before surgical treatment and in the postoperative period, visual acuity, intraocular pressure, Humphrey perimetry, field of vision studies based on screening tests, optical coherence tomography of the retina, and sonography of the optic nerve were performed on patients. The observation period is 1 year. 1 year after surgery, OCT was performed in 60 patients (60 eyes). The average thickness of the neurosensory retina in the foveolar zone was 279.12±1.6 μm, and the thickness of the choroid was 251.7±2.41 μm. When examining the integrity of the pigment epithelium and choriocapillary complex, it was established that in 32 eyes (53.33%) there was a decrease in its optical density, an increase in optical density in 13 eyes (21.67%), in 15 eyes (25.0%) there were no changes fixed The IS/OS layer was preserved in 51 eyes (85.0%), its disorganization was noted in 9 eyes (15.0%).