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Retina
Reattachment rate with pneumatic retinopexy versus pars plana vitrectomy for single break rhegmatogenous retinal detachment
  1. Aurora Pecaku1,2,
  2. Isabela Martins Melo1,2,
  3. Reut Shor1,2,
  4. Carolina L M Francisconi1,2,
  5. Samara Barbara Marafon1,2,
  6. Varun Chaudhary3,
  7. Roxane Jo Hillier4,
  8. Rajeev H Muni1,2,5
  1. 1Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada
  2. 2Department of Ophthalmology, St. Michael’s Hospital, Unity Health Toronto, Toronto, Ontario, Canada
  3. 3Department of Surgery, Division of Ophthalmology, McMaster University, Hamilton, Ontario, Canada
  4. 4Department of Ophthalmology, Royal Victoria Infirmary, Newcastle upon Tyne, UK
  5. 5Kensington Vision and Research Institute, Toronto, Ontario, Canada
  1. Correspondence to Dr Rajeev H Muni; rajeev.muni{at}gmail.com

Abstract

Aim To assess the primary reattachment rate (PARR) in pneumatic retinopexy (PnR) versus pars plana vitrectomy (PPV) for rhegmatogenous retinal detachment (RRD) meeting the Pneumatic Retinopexy versus Vitrectomy for the Management of Primary Rhegmatogenous Retinal Detachment Outcomes Randomised Trial (PIVOT) criteria with a single break in detached retina.

Methods A post hoc analysis of two clinical trials. To be included, patients with primary RRD had to meet PIVOT criteria but could have only one break in the detached retina. Patients with additional pathology in the attached retina were included in a secondary analysis. The primary outcome was PARR following PnR versus PPV at 1-year postoperatively.

Results 162 patients were included. 53% (86/162) underwent PnR and 47% (76/162) had a PPV. 99% (85/86) and 86.8% (66/76) completed the 1-year follow-up visits in the PnR and PPV groups, respectively. PARR was 88.2% (75/85) in the PnR group and 90.9% (60/66) in the PPV group (p=0.6) with a mean postoperative logMAR best-corrected visual acuity of 0.19±0.25 versus 0.34±0.37 (Snellen 20/30 vs 20/44) (p=0.01) each in the PnR and PPV groups, respectively.

In an additional analysis of patients who were also allowed to have any pathology in the attached retina, the PARR was 85% (91/107) and 91.6% (66/72) in the PnR and PPV groups, respectively (p=0.18).

Conclusions PnR and PPV provide similar long-term PARR in a substantial proportion of patients meeting PIVOT criteria with only a single break in the detached retina. Therefore, in patients meeting these specific criteria, PnR is an appropriate first-line therapy as it offers superior functional outcomes without compromising PARR.

  • Retina
  • Ophthalmologic Surgical Procedures

Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information.

https://doi.org/10.1136/bjo-2023-324005

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    Data availability statement

    All data relevant to the study are included in the article or uploaded as supplementary information.

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    Footnotes

    • X @marafon_sbm, @roxanehillier

    • Contributors RHM had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. RHM is responsible for the overall content as the guarantor. Concept and design: RHM and AP. Acquisition, analysis or interpretation of the data: all authors. Drafting of the manuscript: RHM, AP and IMM. Critical review of the manuscript for important intellectual content: all authors. Administrative, technical or material support: RHM, AP and RS. Supervision: RHM.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests The authors report no conflicts of interest related to the content of the manuscript. The authors alone are responsible for the content and writing of the paper.

    • Provenance and peer review Not commissioned; externally peer reviewed.