July 2018
Volume 59, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2018
Surgical Success and Functional Outcomes of Failed Pneumatic Retinopexy for Primary Rhegmatogenous Retinal Detachment
Author Affiliations & Notes
  • Zaid Mammo
    Ophthalmology, Columbia University, New York, New York, United States
  • Rosanna Martens
    Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, British Columbia, Canada
  • Andrew Merkur
    Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, British Columbia, Canada
  • Andrew Kirker
    Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, British Columbia, Canada
  • David Albiani
    Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, British Columbia, Canada
  • C Gustavo De Moraes
    Ophthalmology, Columbia University, New York, New York, United States
  • Stanley Chang
    Ophthalmology, Columbia University, New York, New York, United States
  • David Maberley
    Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, British Columbia, Canada
  • Footnotes
    Commercial Relationships   Zaid Mammo, None; Rosanna Martens, None; Andrew Merkur, None; Andrew Kirker, None; David Albiani, None; C Gustavo De Moraes, None; Stanley Chang, None; David Maberley, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2018, Vol.59, 4248. doi:
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      Zaid Mammo, Rosanna Martens, Andrew Merkur, Andrew Kirker, David Albiani, C Gustavo De Moraes, Stanley Chang, David Maberley; Surgical Success and Functional Outcomes of Failed Pneumatic Retinopexy for Primary Rhegmatogenous Retinal Detachment. Invest. Ophthalmol. Vis. Sci. 2018;59(9):4248.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To evaluate the functional and anatomical outcomes of patients who failed pneumatic retinopexy (PR) as a primary treatment for rhegmatogenous retinal detachment (RRD).

Methods : Retrospective consecutive case series of all failed primary PRs at a tertiary referral centre. Six-month anatomical and functional outcomes of secondary interventions were compared: scleral buckle (SB), pars-plana vitrectomy (PPV) and combined PPV and SB (PPV+SB). The data was analyzed using Fisher’s exact test and ANOVA.

Results : Out of 267 patients with RRD treated with PR over 18 months, 73 failed cases were included. All patients had six-month follow-up data. Average time to failure was 12 +/-29 days (SD). Among failed cases, 60% required a secondary intervention within 3 days of the original procedure. Missed or new retinal tears were responsible to almost 50% of all failures. Percentage of failures attributed to proliferative vitreoretinopathy (PVR) was 4%, 20% and 44% in the PPV, SB and PPV+SB group, respectively (p<0.01). At time of failure, a trend towards increased macula-involved RRD was noted in the combined PPV+SB group (78%), SB (47%) and PPV (47%)(p=0.34). The combined single secondary intervention anatomical success rate post-failed PR was 93% (SB (87%, n=15), PPV (96% n=49), and PPV+SB (89%, n=9) (p=0.33)). Visual acuity (logMAR [Snellen acuity equivalent]) at initial presentation and post-PR failure were similar for the SB (1.01 [20/202] and 0.76 [20/116], PPV (1.07 [20/237] and 0.98 [20/189] and PPV+SB (1.36[20/459] and 1.58[20/764]) groups (p=0.71 and p=0.14), respectively. Both the SB (0.18[20/30]) and PPV (0.28[20/38]) groups had better VA at final follow-up compared to the combined SB+PPV group (0.92 [20/166] (p<0.01).

Conclusions : Among patients who failed PR for RRD, there were equivalent anatomical outcomes observed for SB, PPV and PPV+SB. However, patients receiving SB and PPV had superior functional outcomes at six-month follow up compared to PPV+SB. This may be influenced by the the greater percentage of PVR at time of failure and trends towards increased macula-involvement at that point, as well as trends of worse initial and post-PR failure visual acuity within the PPV+SB group.

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.

 

Anatomical and functional outcomes of secondary interventions after failed pneumatic retinopexy for rhegmatogenous retinal detachment. Visual acuity (VA) (logMAR[Snellen acuity equivalent]).

Anatomical and functional outcomes of secondary interventions after failed pneumatic retinopexy for rhegmatogenous retinal detachment. Visual acuity (VA) (logMAR[Snellen acuity equivalent]).

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