Pneumatic retinopexy (PnR) is a condition associated with reduced vertical metamorphosis and greater visual acuity compared to pars plana vitrectomy (PPV) for primary rhegmatogenous retinal detachment (RRD). However, the integrity of postoperative photoreceptor integrity with both these surgical techniques has not been determined. This study aims to compare the photoreceptor integrity between PnR and PPV.

This post hoc analysis included a total of 150 participants who required retinal detachment repair. The eligible participants were randomly assigned to PNR or PPV stratified by macular status. The primary outcome of the study was the difference in the proportion of patients with discontinuity of the external limiting membrane (ELM) or ellipsoid zone (EZ).

Analyzing the central 3-mm scans revealed that 24% vs. 7% demonstrated EZ continuity and 20% vs. 6% showed ELM discontinuity in PPV and PVR groups, respectively. Analyzing 6-mm scans showed that ELM and EZ discontinuity was more significant in the PPV vs. PNR groups.

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The research concluded that the discontinuity of ELM and EZ was more common in postoperative patients with PPV vs. PnR for RRD repair. These findings suggest that less continuity of ELM and EZ could provide an anatomic basis for previously reported positive outcomes with PnR.