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Rajeev Hemant Muni, Motaz Bamakrid, Quratulain Paracha, Shicheng Jin, Carolina Francisconi, Verena Juncal; Real-World Evidence of Anatomical Success Rates and Visual Acuity Outcomes of Pneumatic Retinopexy in Patients with Primary Rhegmatogenous Retinal Detachment meeting PIVOT Trial Criteria.. Invest. Ophthalmol. Vis. Sci. 2019;60(9):6599.
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To assess real-world, long term anatomical and visual outcomes of pneumatic retinopexy for patients presenting with primary rhegmatogenous retinal detachment meeting PIVOT criteria.
DESIGNRetrospective cohort study.METHODSPatients fulfilling PIVOT trial criteria from an academic vitreoretinal practice that underwent Pneumatic Retinopexy (PnR) for primary rhegmatgenous retinal detachment from Oct 1, 2009 to January 31, 2017 having minimum 3 months follow-up were included in the study. To meet PIVOT trial criteria, patients must have had a single retinal break or group of breaks within 1 clock hour in detached retina, above the 8 and 4 o’clock meridians with no significant proliferative vitreoretinopathy. Patients could have had any number and size of breaks in detached retina. Primary anatomical success rate was determined at 1 year and Log Mar visual acuity was recorded preoperatively, and at 1,3 and 6 months and 1 and 2 years post-operatively.
A total of 371 patients were included in the study. Among these, 291 (78.4%) patients had successful retinal reattachment following PnR, while 80 (21.4%) patients underwent an additional procedure. Among those patients who had a PnR failure (n=80), retinal reattachment was achieved in 52 (65%) patients with only PPV, 20 (25%) patients with PPV and scleral buckle, 3 (3.8%) patients with only scleral buckle, and 5 (6.3%) patients with repeated PnR.Mean Log Mar visual acuity at 3 months (n=259), 6 months (n=256), 1 year (n=236) and 2 years (n=143) were 0.48±0.61, 0.36±0.45, 0.35±0.44, and 0.35±0.50 respectively, compared to 0.96±1.0 at baseline which were all statistically significant improvements (p<0.00001).Following pneumatic retinopexy, PPV for epiretinal membrane peeling was performed in 7 (2.3%) patients and in 2 (0.6%) patients for macular hole, while 1 (0.3%) patient had PPV for Intraocular Lens repositioning.
Real-world evidence from this study demonstrates a primary anatomical success rate of 78.4% with pneumatic retinopexy which is comparable to the 81% success rate seen in the PIVOT TRIAL for patients meeting clinical trial criteria. Patients undergoing primary pneumatic retinopexy had good visual acuity outcomes with limited need for additional surgery.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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