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Parisa Emami-naeini, Vivian S Vuong, Steven Tran, Lawrence S Morse, Ala Moshiri, Susanna S Park, Glenn Yiu; Outcomes of Pneumatic Retinopexy Performed by Vitreoretinal Fellows for Rhegmatogenous Retinal Detachment. Invest. Ophthalmol. Vis. Sci. 2017;58(8):4152. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate anatomic and visual outcomes of patients with rhegmatogenous retinal detachment who underwent pneumatic retinopexy performed by vitreoretinal fellows
We collected demographic information, preoperative characteristics, procedure details, fellow training level, postoperative anatomic and visual outcomes at 3 and 6 months, and need for additional procedures on 198 patients with rhegmatogenous retinal detachment who underwent pneumatic retinopexy by vitreoretinal fellows. Chi-square and Student’s t-test were used to compare single-operation and final anatomic success, as well as visual outcomes between first and second-year fellows. Regression analysis was performed to determine the association of preoperative characteristics, procedure details, and fellow training level on visual and anatomic outcomes.
Single-procedure success rate was 63.6% at 3-months and 59.5% at 6-months. Final anatomical reattachment was achieved in 92.9% (n = 184) and 96.6% (n = 143 eyes) at 3- and 6-months. Mean logMAR (logarithm of the minimum angle of resolution) visual acuity improved from 0.72 ±0.1 at baseline (~20/100 Snellen acuity) to 0.36±0.06 at 6-months (~20/40 Snellen acuity; P < 0.001). There was no statistically significant difference in anatomical success rates (P = 0.74 - 0.97) or visual outcomes (P=0.39 - 0.77) between cases performed by first- or second-year fellows at both 3 and 6 months. Only identified factor associated with lower single-procedure success was larger size of retinal detachment at baseline, with ≥4 clock hours detachment showing lower success rate at 3 (54.9% vs. 70.8%, P = 0.01) and 6 months (47.7% vs. 68.3%, P = 0.01). Visual outcome at 6 months was associated with size of RD (P = 0.02), macula status (attached or detached) at baseline (P = 0.02), and number of reoperations (P = 0.02). Fellowship training level (first vs. second year) did not affect single-procedure or final anatomic success, or visual outcome (all P>0.05).
Final anatomic and visual outcomes of fellow-performed pneumatic retinopexy are comparable to reported outcomes of retina specialists in previous literature.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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