Abstract
Purpose :
Since its introduction in 1986, pneumatic retinopexy (PR) has been an effective procedure to repair select rhegmatogenous retinal detachments (RRD). However, in cases of re-detachment following PR, it is unclear which surgical option offers the best chance of reattachment. A retrospective observational clinical study was performed to examine the success rate of different surgical approaches to secondary RRD repair originally managed with PR.
Methods :
A retrospective chart review was performed on patients presenting with RRD to four different doctors at the Retina Consultants of Hawaii from February 1, 2013 to December 31, 2019. Patients treated with PR for RRD repair who subsequently experienced a re-detachment were included in this study. Data collected included affected eye, date and type of procedures, and postoperative retina attachment status. A successful case was defined as an attached retina with no recurrence of retinal breaks or tears after one month following surgery. Cases where silicone oil remained in the post-operative eye or lacked a sufficient follow up time of three months after oil removal were excluded from the study. A Fisher’s exact test was used to compare the success rate of different surgical approaches, a p value <0.05 was considered statistically significant.
Results :
There were 15 eyes included in this study. Of these, 40% (6/15 eyes) were managed with pars plana vitrectomy (PPV) (3 with gas and 3 oil), 40% (6/15 eyes) were managed with a combination scleral buckle with PPV (5 with gas and 1 oil), and 20% (3/15 eyes) were managed with a repeat PR. The success rate was 50% for PPV, 83% for combination scleral buckle with PPV, and 0% for repeat PR. The success rate of reattachment with combination scleral buckle with PPV was significantly higher than with repeat PR (p=0.048). There was no significant difference in success rate between PPV vs. combination scleral buckle with PPV (p=0.242).
Conclusions :
This study shows significantly better surgical outcomes when treating a failed PR RRD repair with combination scleral buckle with PPV rather than with a secondary PR. It raises the possibility that a scleral buckle is not necessary following a failed PR. Due to the small sample size and retrospective nature of the study, additional examination would be useful to further elucidate the best surgical approach following a failed PR.
This is a 2021 ARVO Annual Meeting abstract.