12-Month Outcomes of Pneumatic Retinopexy for Primary Rhegmatogenous Retinal Detachment in a Japanese Cohort: a Multicenter Study

Abstract

Purpose : To evaluate the outcomes of pneumatic retinopexy (PnR) over a 12-month follow-up period for the treatment of rhegmatogenous retinal detachment (RRD) in a Japanese population.

Methods : In this multicenter study, eyes treated for initial RRD with PnR from December 2020 to November 2022 and were followed for 12 months were retrospectively assessed in terms of the primary anatomical reattachment rate (PARR) and visual acuity outcomes. The criteria for inclusion in the current analyses were similar to those applied in the PIVOT clinical trial (Ophthalmology, 2019): retinal breaks (single or multiple) within the upper 240 degrees (8 o'clock to 4 o'clock), distribution of the retinal breaks ≤ 30 degrees, and inferior breaks or lattice degeneration in the attached retina being allowed if photocoagulation was performed prior to gas injection. Eyes with PVR≥grade C were excluded. The treatment was performed with the following steps: (1) anterior chamber fluid drainage, (2) intravitreal injection of 100% SF6 gas (0.4-0.8 cc), (3) positioning based on the location of the causative retinal breaks, including the steam-roller procedure when needed, and (4) retinal photocoagulation after reattachment of the retinal breaks. The post-operative best-corrected visual acuities (BCVAs) at 6-months and 12-months were compared to preoperative BCVA, and the PARR was assessed throughout the study period. Information of adverse events were also collected from the medical record.

Results : Of 58 eyes treated with PnR during the study period, 28 eyes met the inclusion criteria and were included in the analyses. BCVA (logMAR) significantly improved from 0.34±0.70 preoperatively to 0.04±0.26 at 6 months postoperatively and 0.02±0.25 at 12 months postoperatively (Friedman's test, p=0.02). The PARR was 92.9% (26 out of 28 eyes). Failure in two cases was caused by redetachment from the original break in one case and formation of a new break in another case. Secondary reattachment was achieved with pars plana vitrectomy in these eyes. Neither intra-operative nor post-operative adverse events were documented in association with the PnR procedures.

Conclusions : Favorable anatomical and visual acuity outcomes were demonstrated over 12 months after PnR in a Japanese population when performed in eyes meeting the previous clinical trial criteria.

This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.