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D. L. Pomerleau, R. Roe, J. M. Jumper; Outcomes in Pneumatic Retinopexy Appear to Be Influenced by Gender. Invest. Ophthalmol. Vis. Sci. 2009;50(13):6088.
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Pneumatic retinopexy (PR) is an increasingly popular method for managing rhegmatogenous retinal detachments (RD) with superior retinal breaks. The impact of gender on the success of this procedure is not entirely clear, with some studies showing a trend toward greater single-operation-success (SOS) rates in women and others showing equal success rates in men and women. Our study examined the effect of gender on the success of PR at a single practice over a 2-year period.
A retrospective chart review was performed, examining records of 150 patients (106 men and 44 women) who underwent primary PR for rhegmatogenous RD in a single practice over a two-year period from 2006-2007. Data collected included patient demographics and baseline characteristics of the RD, details of the PR procedure, need for additional procedures, duration of follow-up, attachment status at last follow-up, and visual acuity at presentation and last follow-up. Men and women were compared with respect to baseline characteristics, outcomes, and SOS rate.
Baseline characteristics of the presenting RD and modes of treatment were similar between men and women. The overall SOS rate was 68.7%, with a final reattachment rate of 98% after additional procedures. The SOS rate was 66% in men and 75% in women (p=0.27). New retinal breaks were the most common reason for PR failure in men (44%), followed by persistent RD (31%) and recurrent RD (after successful reattachment - 11%). Recurrent RD was the most common reason for PR failure in women (45%), followed by formation of new breaks (27%) and persistent RD (18%).
There appears to be a trend toward greater success rates of PR in women, but this was not statistically significant in our study. Men are more likely to develop new retinal breaks and to fail initial reattachment, while women appear more likely to succeed at initial reattachment and experience later failures due to recurrent detachment. The reasons for these differences are not clear, but may be related to positioning and compliance, suggesting that men may need greater educational effort when PR is performed.
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