Factors Associated With Outcomes of Pneumatic Retinopexy for Rhegmatogenous Retinal Detachments

Gilca, Marina; Duval, Renaud; Goodyear, Émilie; Olivier, Sébastien; Cordahi, Ghassan

doi:10.1097/iae.0b013e3182a2e6ee

Cited by 24 publications

(33 citation statements)

References 16 publications

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“…Additionally, the seminal randomized, controlled trial by Tornambe et al reported a 73% SOS rate with PR. 3 Two studies published in 2013 have reported SOS rates of 66.3% 19 and 60.7%, 20 respectively, which are consistent with the SOS from the current study.…”

Section: Discussionsupporting

confidence: 91%

Outcomes and Complications of Pneumatic Retinopexy Over a 12-Year Period

Modi¹,

Epstein²,

Flynn³

et al. 2014

Ophthalmic Surg Lasers Imaging Retina

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Section: Discussionsupporting

confidence: 91%

Outcomes and Complications of Pneumatic Retinopexy Over a 12-Year Period

Modi¹,

Epstein²,

Flynn³

et al. 2014

Ophthalmic Surg Lasers Imaging Retina

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“… 16 This is in sharp contrast to the findings of this study and the lower rates reported by three recent studies that demonstrated a range of 60.7%–69.6%. 13 , 14 , 17 …”

Section: Discussionmentioning

confidence: 99%

“… 6 Two recent large retrospective studies that investigated the risk factors for failure of PR reported an initial anatomical success rate of 61%–63.3% with a final rate of 96.1%–99.2%. 13 , 14 …”

Section: Introductionmentioning

confidence: 99%

Reassessment of pneumatic retinopexy for primary treatment of rhegmatogenous retinal detachment

Cohen¹,

Zerach²,

Barak³

2015

OPTH

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BackgroundPneumatic retinopexy (PR) remains a popular technique for the treatment of rhegmatogenous retinal detachment (RRD).ObjectiveTo evaluate the single operation and final success rate of PR for primary treatment of RRD and to determine factors associated with anatomical and visual outcomes.MethodsThis retrospective case review study analyzed the data of patients who underwent PR for primary treatment of RRD. Patients with a follow-up period of <2 months were excluded. Single operation success was defined as successful retinal reattachment following a single PR throughout 2 months of follow-up.ResultsEighty-four eyes met the inclusion criteria. Single operation success was achieved in 50 eyes (59.5%), while 82 obtained anatomical success at the final follow-up visit (97.6%). An average of 0.702±1.095 additional retinal detachment operations was necessary to achieve final anatomical success in the entire cohort (n=84) and 1.4±1.3 in the single operation failure group (n=34). Both groups (single operation success vs failure) did not differ significantly in any of the preoperative variables. Multivariate analysis of pseudophakic patients (n=22) revealed that 52.65% of the variation in single operation outcome was explained by the number of clock-hours detached (partial R2=43.76%, P=0.001). The final best-corrected visual acuity was significantly better in the single operation success group (logarithm of minimum angle [logMAR] 0.229±0.249 vs logMAR 0.747±0.567, P<0.001).ConclusionCareful patient selection is warranted before performing PR in RRD, particularly in pseudophakic patients with large detachments. Ultimately 60% of the cases will attach after the procedure with the rest requiring on average 1.4 additional procedures to achieve final anatomical success.

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“…All types of PR use the injection of an expanding gas bubble, without PPV, combined with laser photocoagulation or cryopexy to seal the retinal tear. Traditionally, PR is used for cases of RRD with specific preoperative characteristics: uncomplicated RRD with retinal breaks in the superior region (i.e., around the 8 o'clock position) or multiple superior breaks confined to a single clockwise sector, with a clear vitreous (Tornambe et al 1991;Gilca et al 2014). Recently, PR for primary repair of RRD has been reported to result in successful anatomic outcomes in about 75% of cases, including cases with various preoperative characteristics (Jung et al 2019 Older RRD patients with retinal tears in various regions, including GRT and PVR.…”

Section: Pneumatic Retinopexymentioning

confidence: 99%

“…That study found that PR resulted in superior VA, less vertical metamorphopsia, and reduced morbidity when compared with PPV. However, many reports have shown that the primary reattachment rate after PR is not very high (about 60-80%) (Han et al 1998;Gilca et al 2014;Goldman et al 2014;Hillier et al 2019;Jung et al 2019), in contrast with high reattachment rates after PPV (more than 90%) (Han et al 1998;Kunikata and Nishida 2010). Thus, PR is recommended in RRD patients with retinal tears in the superior region who desire to have the best possible visual function, even if additional procedures are needed, while PPV is recommended in patients with retinal tears in various regions who desire to avoid reoperations, regardless of the possible impact on visual functional recovery (Table 1).…”

Section: Pars Plana Vitrectomy Vs Pneumatic Retinopexymentioning

confidence: 99%

Historical, Current and Future Approaches to Surgery for Rhegmatogenous Retinal Detachment

Kunikata

Abe

Nakazawa

2019

Tohoku J. Exp. Med.

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Rhegmatogenous retinal detachment (RRD) is a serious condition that can cause blindness without surgical treatment. RRD occurs when a retinal tear or hole allows fluid to accumulate below the retinal surface, causing the retina to separate from the underlying layers. RRD is difficult to treat because each case is unique, varying with the location, size, and duration of the detachment, as well as patient age. The first successful methods to reattach the retina in RRD used thermocautery to repair the detachment. Many renowned ophthalmologists continued to study RRD and developed many new surgical approaches, notably: scleral buckling (SB), in which a silicone band is placed around the eye to reduce traction on the retina caused by the vitreous humor that fills the eye; pars plana vitrectomy (PPV), which eliminates traction on the retina by removing the vitreous; and pneumatic retinopexy (PR), in which the retina is reattached by pushing it back into place with an expanding gas bubble injected into the eye. However, no consensus has been reached on which approach is ideal. Furthermore, recent surgical and non-surgical breakthroughs, such as artificial vitreous substitutes and neuroprotective drugs, must also be considered. Thus, this review provides a guide for ocular specialists and non-specialists on the historical background of RRD, summarizes the three current main techniques (SB, PR and PPV) compares these three techniques, and provides an overview of new technologies that promise to greatly improve outcomes after RRD surgery.

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Factors Associated With Outcomes of Pneumatic Retinopexy for Rhegmatogenous Retinal Detachments

Abstract: Several factors are associated with pneumatic retinopexy outcomes for rhegmatogenous retinal detachments. These factors should be taken into consideration when identifying patients who would benefit from pneumatic retinopexy and those who are at risk of requiring additional interventions.

Cited by 24 publications

References 16 publications

Outcomes and Complications of Pneumatic Retinopexy Over a 12-Year Period

Outcomes and Complications of Pneumatic Retinopexy Over a 12-Year Period

Reassessment of pneumatic retinopexy for primary treatment of rhegmatogenous retinal detachment

Historical, Current and Future Approaches to Surgery for Rhegmatogenous Retinal Detachment

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