Rate and Rationale for Vitrectomy after Pneumatic Retinopexy

Area of Science:

• Ophthalmology
• Retinal Surgery
• Public Health

Background:

• Pneumatic retinopexy (PnR) is a common surgical technique for retinal detachment (RD) repair.
• Pars plana vitrectomy (PPV) is another surgical option for RD and other retinal conditions.
• Understanding the rate and reasons for PPV after PnR is crucial for patient counseling and surgical planning.

Purpose of the Study:

• To determine the incidence of pars plana vitrectomy (PPV) after pneumatic retinopexy (PnR) for retinal detachment (RD) repair.
• To identify the indications for non-RD PPV following PnR.
• To compare visual acuity (VA) outcomes between eyes undergoing non-RD PPV and other management strategies.

Main Methods:

• Retrospective, nonrandomized comparative study using the IRIS® Registry (04/01/2013 to 12/31/2021).
• Inclusion/exclusion criteria applied via billing codes to define three groups: Group 1 (non-RD PPV post-PnR), Group 2 (no surgery post-PnR), Group 3 (RD requiring surgical repair post-PnR).
• Analysis of subsequent PPV indications, follow-up duration, and visual acuity (VA).

Main Results:

• 9,107 eyes were analyzed; 9.4% (556 eyes) required a non-RD PPV after PnR reattachment.
• Common indications for non-RD PPV included internal limiting membrane (25.7%) and epiretinal membrane removal (18.3%).
• Final VA was similar to eyes requiring surgical RD repair (Group 3) but lower than eyes not needing further surgery (Group 2); follow-up was longer than both groups.

Conclusions:

• Approximately 1 in 10 eyes treated with PnR for RD may necessitate a subsequent non-RD PPV.
• Visual outcomes after non-RD PPV are comparable to those requiring surgical RD repair.
• The potential need for PPV should be discussed during patient counseling for PnR.