Outcomes after Failed Pneumatic Retinopexy for Retinal Detachment

Abstract

Anatomic success rates for secondary PR, PPV, and SB+PPV after failed PR were lower than published success rates for their use in primary RD. This suggests that a failed primary PR selects for RDs that are inherently more difficult to reattach. There was a trend suggesting that anatomic success rates are greater with SB+PPV than PPV and, in turn, with PPV than repeat PR. However, these differences were not statistically significant and did not translate into better VA gains at 1 year for either procedure. The suitable procedure after failed PR thus depends on patient presentation, surgeon preference, and patient preference.

The Role of Pneumatic Retinopexy: Lessons Learned and Keys to Successful Outcomes

“…A recent study from our institution found that the median time to failure was 6 days, with the majority of cases (80%) failing within the first month. 7 Regarding which procedure to select after a pneumatic fails, this study also found a nonsignificant trend favoring buckle-vitrectomy over straight vitrectomy over repeat pneumatic. 7…”

“…7 Regarding which procedure to select after a pneumatic fails, this study also found a nonsignificant trend favoring buckle-vitrectomy over straight vitrectomy over repeat pneumatic. 7…”

“…5 In our institution, overall pneumatic retinopexy success is 79%, with a nonstatistically significant trend toward better results with more conservative patient selection. 6,7 In the ideal situation, there are numerous advantages to pneumatic retinopexy over the surgical options performed in an operating room, including the potential for better visual outcomes, avoiding the complications of intraocular surgery and anesthesia, immediate access, and reduced cost. Disadvantages include a lower single-surgery success rate than surgical procedures in the operating room, an increased likelihood of requiring a second procedure (cryoretinopexy, laser retinopexy, vitrectomy, and/or scleral buckle), and increased time spent in clinic for thorough examination preoperatively and postoperatively.…”

Pneumatic retinopexy outcomes as primary or secondary surgical option for treating rhegmatogenous retinal detachment

“…After a failed PR, on an average, 1.4 procedures were required for reattachment and no difference was seen in visual outcome in a study by Anaya et al . [ 19 ]…”

Management of recurrent rhegmatogenous retinal detachment

“…Majority of the studies quote PVR ≥ Grade C, anterior and inferior PVR to be associated with a higher risk re-RD. [ 6 7 8 9 10 11 12 13 14 15 16 17 19 20 21 22 26 ] It was previously reported that 86% of eyes with re-RD after vitrectomy have a component of anterior PVR[ 27 ] and eyes with anterior PVR have poorer surgical prognosis than those with posterior PVR. [ 28 ]…”