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Clinical Sciences
Journal Club
February 2013

Pneumatic Retinopexy for the Repair of Primary Rhegmatogenous Retinal Detachment: A 10-Year Retrospective Analysis

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Author Affiliations

Author Affiliations: Dr Pinchas Borenstein Talpiot Medical Leadership Program 2012 (Dr Fabian) and the Goldschleger Eye Institute, Sheba Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel (Drs Fabian, Kinori, Efrati, Alhalel, Desatnik, Vidne Hai, Katz, Platner, and Moisseiev).

JAMA Ophthalmol. 2013;131(2):166-171. doi:10.1001/2013.jamaophthalmol.361

Objective To assess the outcome and risk factors for failure of pneumatic retinopexy (PR) in eyes with primary rhegmatogenous retinal detachment (RRD).

Methods Data of patients who underwent PR for the repair of primary RRD, from January 1, 2000, through June 30, 2011, were retrieved from medical records and retrospectively analyzed. Patients with a follow-up time of less than 4 months were contacted and invited for examination. Patients with less than 2 months of follow-up were excluded. Successful cases (attached retina at 2 months after the PR) were compared with failures. A subgroup analysis was performed comparing successful and failed cases of RRD that were reattached with only 1 additional operation.

Results Two hundred seventy-six eyes (271 patients) underwent PR during the study period, of which 258 eyes (93.5%) were included in the study. Mean (SD) follow-up time was 36.1 (39.4) months; only 23 eyes (8.9%) had a follow-up of less than 4 months. Successful reattachment at 2 months was achieved in 171 eyes (66.3%). Sixty-seven eyes (77.0% of the failed cases) were reattached with only 1 additional operation and final anatomical success was achieved in 256 eyes (99.2%). Successful cases had significantly better final vision (P = .002) and fewer postoperative complications (P ≤ .026). However, nonsignificant differences were found between the primary failure PR cases that underwent only 1 additional operation and the successful cases (P ≥ .073).

Conclusions Pneumatic retinopexy is a good surgical option for primary RRD. Most cases of primary failure are reattached with 1 additional procedure and have excellent final vision.