Reattachment rate with pneumatic retinopexy versus pars plana vitrectomy for single break rhegmatogenous retinal detachment.

Autor:	Pecaku A; Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada.; Department of Ophthalmology, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada., Martins Melo I; Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada.; Department of Ophthalmology, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada., Shor R; Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada.; Department of Ophthalmology, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada., Francisconi CLM; Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada.; Department of Ophthalmology, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada., Marafon SB; Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada.; Department of Ophthalmology, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada., Chaudhary V; Department of Surgery, Division of Ophthalmology, McMaster University, Hamilton, Ontario, Canada., Hillier RJ; Department of Ophthalmology, Royal Victoria Infirmary, Newcastle upon Tyne, UK., Muni RH; Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada rajeev.muni@gmail.com.; Department of Ophthalmology, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada.; Kensington Vision and Research Institute, Toronto, Ontario, Canada.
Jazyk:	angličtina
Zdroj:	The British journal of ophthalmology [Br J Ophthalmol] 2024 Aug 19. Date of Electronic Publication: 2024 Aug 19.
DOI:	10.1136/bjo-2023-324005
Abstrakt:	Aim: To assess the primary reattachment rate (PARR) in pneumatic retinopexy (PnR) versus pars plana vitrectomy (PPV) for rhegmatogenous retinal detachment (RRD) meeting the Pneumatic Retinopexy versus Vitrectomy for the Management of Primary Rhegmatogenous Retinal Detachment Outcomes Randomised Trial (PIVOT) criteria with a single break in detached retina. Methods: A post hoc analysis of two clinical trials. To be included, patients with primary RRD had to meet PIVOT criteria but could have only one break in the detached retina. Patients with additional pathology in the attached retina were included in a secondary analysis. The primary outcome was PARR following PnR versus PPV at 1-year postoperatively. Results: 162 patients were included. 53% (86/162) underwent PnR and 47% (76/162) had a PPV. 99% (85/86) and 86.8% (66/76) completed the 1-year follow-up visits in the PnR and PPV groups, respectively. PARR was 88.2% (75/85) in the PnR group and 90.9% (60/66) in the PPV group (p=0.6) with a mean postoperative logMAR best-corrected visual acuity of 0.19±0.25 versus 0.34±0.37 (Snellen 20/30 vs 20/44) (p=0.01) each in the PnR and PPV groups, respectively.In an additional analysis of patients who were also allowed to have any pathology in the attached retina, the PARR was 85% (91/107) and 91.6% (66/72) in the PnR and PPV groups, respectively (p=0.18). Conclusions: PnR and PPV provide similar long-term PARR in a substantial proportion of patients meeting PIVOT criteria with only a single break in the detached retina. Therefore, in patients meeting these specific criteria, PnR is an appropriate first-line therapy as it offers superior functional outcomes without compromising PARR. Competing Interests: Competing interests: The authors report no conflicts of interest related to the content of the manuscript. The authors alone are responsible for the content and writing of the paper. (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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