Ophthalmol Retina. 2023 Jul 15:S2468-6530(23)00312-3. doi: 10.1016/j.oret.2023.07.010. Online ahead of print.
ABSTRACT
PURPOSE: To assess real-world primary anatomic reattachment rate and postoperative visual acuity outcomes in patients aged 75 years or older who underwent pneumatic retinopexy (PnR) for primary rhegmatogenous retinal detachment (RRD).
DESIGN: A retrospective cohort study.
SUBJECTS: Patients aged 75 years or older with primary RRD undergoing PnR.
METHODS: This study evaluates real-world outcomes from Oct 1, 2010, to December 31, 2022, of eligible patients with a minimum of 3 months follow-up. There were no limitations with respect to the number, size or location of retinal breaks. Exclusion criteria included significant proliferative vitreoretinopathy or previous retinal detachment repair in the index eye, inability to maintain the postoperative posturing requirements (such as physical disability), very inferior breaks below 5 or 7 o’clock) or inability to carry out adequate examination of the peripheral retina due to media opacity. Lens status did not impact decision to offer PnR.
MAIN OUTCOME MEASURES: PnR primary anatomic reattachment rate and postoperative visual acuity (VA) at 3 months.
RESULTS: 80 patients with a mean age of 80.6±4.6 years were included in this study. 35% (28) were phakic, and 34% (27) presented with a fovea-on RRD. The mean number of breaks in the detached retina was 1.52±1.13, and the mean number of quadrants of detached retina was 2.35±0.93. The primary anatomic reattachment rate at 3 months following PnR was 78.8% (63/80), while the remaining 21.2% (17/80) failed PnR and underwent an operating room procedure. There was a statistically significant improvement in LogMAR VA from baseline to 3 months (1.29±0.94 and 0.69±0.67, respectively, p<0.001). A subgroup analysis that only included patients above the age of 80 was also performed, with a total of 39 patients with a mean age of 84.4±3.5 years. Primary anatomic reattachment rate with PnR in this subgroup was 74.4% (29/39) with a statistically significant improvement in LogMAR VA from baseline to 3 months (1.4±1.05 and 0.77±0.70, respectively, p=0.004).
CONCLUSION: Patients aged 75 years and above or aged 80 years and above treated with PnR for primary RRD had primary anatomic reattachment rates of 78.8% and 74.4%, respectively. These are relatively comparable primary reattachment rates in this age group with other surgical techniques such as pars plana vitrectomy (PPV), scleral buckle (SB) or PPV/SB. Pneumatic retinopexy is an effective, minimally invasive office-based procedure which may be desirable for some elderly patients.
PMID:37459912 | DOI:10.1016/j.oret.2023.07.010
