Reassessment of pneumatic retinopexy for primary treatment of rhegmatogenous retinal detachment

BACKGROUND Pneumatic retinopexy (PR) remains a popular technique for the treatment of rhegmatogenous retinal detachment (RRD). OBJECTIVE To 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. METHODS This 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. RESULTS Eighty-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 R (2)=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). CONCLUSION Careful 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.