Visual and Anatomic Outcomes Following Pneumatic Retinopexy and Practice Pattern Trends.

Abstract

Purpose : To evaluate anatomic and visual outcomes in patients undergoing primary pneumatic retinopexy (PR) for rhegmatogenous retinal detachment (RRD) and the trends of this procedure in a private vitreoretinal practice in northeast Ohio.

Methods : A retrospective review of 144 patients with RRDs who underwent a PR from 2013-2019. Baseline clinical characteristics (age, sex, visual acuity, lens status, presence of lattice degeneration, presence of vitreous hemorrhage, location of retinal breaks, and size of detachment), visual and anatomic outcomes (with a minimum follow-up period of three months), and number of PRs performed per year were evaluated. Main Ouctome is to estimate single-procedure anatomic success rate and final visual acuity following at least a three month follow-up period and their association with clinical outcomes.

Results : Single-procedure anatomic success was achieved in 62.30% of patients. Mean period of follow-up was 17 months [range 2-81 months]. Most of patients who failed initial PR required one additional procedure to achieve reattachment. Factors associated with a higher risk of failure were pseudophakia (p=0.01) and vitreous hemorrhage (p=0.003). Additional retinal tears were the most common cause of failure (53.20%). Epiretinal membrane formation was found in 12.50% of cases and only 2.70% of these patients required surgical intervention. A downward trend in the number of PRs performed per year during the study period (p=0.009) was noted.

Conclusions : Pneumatic retinopexy is still an effective office-based procedure and remains a viable treatment option for rhegmatogenous retinal detachments. Preoperative pseudophakia and vitreous hemorrhage correlate with worse outcomes and should be considered in making a treatment plan. Decreased utilization of PR in recent years can be due to many factors like: the advancement in efficiency and safety of alternative treatment options and rapid accessibility to perform these interventions, especially in a large retinal practice.

This is a 2020 ARVO Annual Meeting abstract.

 

Number of Pneumatic Retinopexy Procedures Per Year