Photo Credit: Yogenyogeny

The following is a summary of “Reattachment rate with pneumatic retinopexy versus pars plana vitrectomy for single break rhegmatogenous retinal detachment,” published in the August 2024 issue of Ophthalmology by Pecaku et al.

Rhegmatogenous retinal detachment (RRD) can be fixed using 2 different procedures: pneumatic retinopexy (PnR) and pars plana vitrectomy (PPV). However, the method meets the Pneumatic Retinopexy vs. Vitrectomy for the Management of Primary Rhegmatogenous Retinal Detachment Outcomes Randomised Trial (PIVOT) criteria with a single break in detached retina is still unsure.

Researchers conducted a prospective study determining the primary reattachment rate (PARR) for PnR vs. PPV in cases of RRD that fit the PIVOT criteria, focusing on those with only 1 break in the detached retina. 

They performed a post hoc analysis of 2 clinical trials, including patients with primary RRD meeting PIVOT criteria but only 1 break in the detached retina. Patients with other issues in the attached retina were analyzed separately. The primary outcome was the PARR for PnR vs. PPV 1 year after surgery.

The result showed that out of 162 patients, 86 (53%) underwent PnR, and 76 (47%) underwent PPV therapy. One-year follow-up was completed by 99% (85/86) in PnR and 86.8% (66/76) in PPV. The PARR was 88.2% (75/85) for PnR and 90.0% (60/66) for PPV (P=0.6). Mean postoperative logMAR visual acuity was 0.19±0.25 for PnR (20/30) and 0.34±0.37 for PPV (20/44) (P=0.01). When including patients with other retinal issues, PARR was 85% (91/107) for PnR and 91.6% (66/72) for PPV (P=0.18).

Investigators concluded that PnR and PPV showed similar long-term PARR for patients with a single retinal break. Therefore, PnR can be a preferred first-line option, providing better functional outcomes without sacrificing the reattachment success rate.

Source: bjo.bmj.com/content/early/2024/08/19/bjo-2023-324005