Primary pneumatic retinopexy (PR) may be effective in achieving single-operation success (SOS) in more than 68% of eyes with noncomplex rhegmatogenous retinal detachment (RRD), according to findings published in JAMA Ophthalmology.
Researchers conducted a retrospective cohort study to describe the clinical outcomes associated with RRD treated primarily with PR. Study data was from the Intelligent Research in Sight (IRIS) Registry, and it included eyes that underwent PR for noncomplex RRD and had at least 3 months of followup. The main outcome measure was the number of eyes that achieved SOS, defined as retinal reattachment without a subsequent retinal detachment surgery or repeated PR.
Of 9553 study participants, 61.0% were men (n=5827) and the mean age was 62 years. SOS was achieved in 68.5% of eyes (n=6613). Between the SOS group (mean 0.24 logMAR) and the single-operation failure (SOF) group (mean 0.43 logMAR), significant differences were noted in best-corrected visual acuity (VA) 9 to 12 months after treatment. The mean time to maximal visual recovery was 268 days among all patients, and endophthalmitis was observed in 0.03% of eyes (n=3). SOS was associated with female sex (95% CI, 1.38-1.65), and SOF was associated with current smoking status (95% CI, 0.68-0.91), the report shows.
Nicolas Yannuzzi, MD, who coauthored the publication, explains that, although it has not historically been a widely-used procedure in the past, PR has existed for decades and is now gaining more traction across North America, and especially in Canada.
“It is one of the ways we can repair retinal detachment without a buckle or vitrectomy, and it’s the only way to reattach the retina without going to the operating room,” says Dr Yannuzzi, who practices at the Bascom Palmer Eye Institute.
The study notes that, when the retinal detachment is not complex and meets certain criteria, PR is one of the more simple and cost-effective options for re-attachment with improved VA.
“The typical guidelines for using PR are that there has to be a single break, a cluster of breaks, and usually those breaks need to be located in the top 8 clock hours,” Dr Yannuzzi notes.
Limitations include those inherent to studies using large databases, such as possible underreporting, as well as possible confounding due to the lack of data on the intent of treating surgeons.
Yannuzzi N, Li C, Fujino D et al. Clinical outcomes of rhegmatogenous retinal detachment treated with pneumatic retinopexy. JAMA Ophthalmology. Published online June 17, 2021. doi:10.1001/jamaophthalmol.2021.1860.