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Anatomic, Visual, and Financial Outcomes for Traditional and Nontraditional Primary Pneumatic Retinopexy for Retinal
Jesse J Jung1, John Cheng2, Jane Y Pan3
1East Bay Retina Consultants, Inc, Oakland, California, USA; Department of Ophthalmology, University of California, San Francisco, San Francisco, California, USA.
American Journal of Ophthalmology
|January 27, 2019
Summary
Pneumatic retinopexy (PR) offers successful anatomic and visual outcomes for rhegmatogenous retinal detachment (RD). While preoperative pseudophakia impacts results, PR remains a cost-effective treatment option compared to other surgical methods.
Area of Science:
- Ophthalmology
- Retinal Surgery
- Surgical Outcomes
Background:
- Rhegmatogenous retinal detachment (RD) is a serious condition requiring timely surgical intervention.
- Pneumatic retinopexy (PR) is a surgical technique used to repair primary RD.
- Traditional (TPR) and nontraditional (NTPR) approaches to PR exist, with varying outcomes.
Purpose of the Study:
- To identify factors predicting anatomic, visual, and financial outcomes following primary pneumatic retinopexy (PR) for rhegmatogenous retinal detachment (RD).
- To compare the cost-effectiveness of traditional versus nontraditional PR.
- To assess the overall success rates of PR in a clinical setting.
Main Methods:
- Retrospective interventional case series analyzing 178 eyes with primary RD treated with PR between 2001 and 2013.
- Patients were categorized into traditional PR (TPR) and nontraditional PR (NTPR) subgroups.
- Outcomes included best-corrected visual acuity (BCVA), anatomic success rates, and cost analysis compared to scleral buckle and vitrectomy.
Main Results:
- An overall success rate of 73.5% was achieved at 1 year postoperatively, with similar rates for TPR (72.8%) and NTPR (74.6%).
- Factors associated with improved BCVA included macula-off detachment and greater clock hours of RD.
- Pseudophakia and inferior retinal tears correlated with worse BCVA, while pseudophakia, inferior quadrant RD, and proliferative vitreoretinopathy were linked to anatomic failure. PR demonstrated significant cost savings compared to scleral buckle and vitrectomy.
Conclusions:
- Pneumatic retinopexy (PR) yields successful anatomic and visual outcomes for primary RD repair, irrespective of the traditional or nontraditional technique used.
- Preoperative pseudophakia is a predictor of poorer visual and anatomic outcomes.
- The comparable costs between TPR and NTPR support the potential cost-effectiveness and expanded indications for PR.
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