Rate and Rationale for Vitrectomy after Pneumatic Retinopexy
Bradley T Smith1, M Zia Siddiqui1, Gautam Vangipuram2
1The Retina Institute of St. Louis, St. Louis, Missouri.
Purpose:
To report the rate and rationale for vitrectomy (PPV) after retinal detachment (RD) repair with pneumatic retinopexy (PnR).
Design:
Retrospective, nonrandomized, comparative study.
Participants:
Intelligent Research in Sight (IRIS Registry) patients undergoing PnR from April 1, 2013, to December 31, 2021.
Methods:
Billing codes were used to apply inclusion/exclusion and define 3 groups for comparison after PnR. Group 1 eyes had a non-RD PPV after PnR. Group 2 did not require a surgical procedure after PnR. Group 3 had RD that required surgical repair after PnR.
Main Outcome Measures:
Subsequent PPV for indications other than RD repair, follow-up duration, and visual acuity (VA).
Results:
In total, 9488 eyes of 9401 patients met the study criteria. The mean age was 65 years, and most were males (60.2%). Of these, 9107 eyes were analyzed according to the inclusion/exclusion criteria. Group 1 included 556 eyes, group 2 included 5351, and group 3 included 3200. In group 1, PPV alone was performed in 30.8% (171 eyes), internal limiting membrane was removed in 25.7% (143 eyes), and epiretinal membrane was removed in 18.3% (102 eyes). Panretinal or focal endolaser photocoagulation was performed with a PPV in 13.3% (74 eyes) and 11.9% (66 eyes), respectively. Average baseline VA in group 1 (0.35 logarithm of the minimum angle of resolution [logMAR], 20/45) was similar to group 2 (0.33 logMAR, 20/43). The mean final VA was lower (0.33 logMAR [20/43] vs. 0.21 logMAR [20/32], P < 0.001), the mean follow-up duration was longer (1516 vs. 1377 days, P < 0.001), and more were male (63.3% vs. 56.1%, P = 0.006). The mean follow-up duration was longer than group 3 (1401 days, P = 0.002), whereas final VA was similar to group 3 (0.38 logMAR [20/48], P = 0.50). Overall, 64.9% (5907 eyes) were reattached using PnR, and 9.4% (556) of these required a non-RD PPV.
Conclusions:
Nearly 1 in 10 eyes required a non-RD PPV after reattachment with PnR. Visual acuity outcomes were similar to eyes requiring surgical repair for RD. The possible need for PPV after reattachment with PnR should be addressed when counseling patients.
Financial Disclosure(S):
Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
