Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2020 Aug 1;138(8):826-833.
doi: 10.1001/jamaophthalmol.2020.2007.

Vision-Related Functioning in Patients Undergoing Pneumatic Retinopexy vs Vitrectomy for Primary Rhegmatogenous Retinal Detachment: A Post Hoc Exploratory Analysis of the PIVOT Randomized Clinical Trial

Rajeev H Muni  1   2   3 , Carolina L M Francisconi  4 , Tina Felfeli  1 , Michael Y K Mak  5 , Alan R Berger  1   2 , David T Wong  1   2 , Filiberto Altomare  1   2 , Louis R Giavedoni  1   2 , Radha P Kohly  1   3   6 , Peter J Kertes  1   3   6 , Natalia Figueiredo  2 , Fei Zuo  7 , Kevin E Thorpe  7   8 , Roxane J Hillier  9   10
Affiliations
Randomized Controlled Trial

Vision-Related Functioning in Patients Undergoing Pneumatic Retinopexy vs Vitrectomy for Primary Rhegmatogenous Retinal Detachment: A Post Hoc Exploratory Analysis of the PIVOT Randomized Clinical Trial

Rajeev H Muni et al. JAMA Ophthalmol. .

Abstract

Importance: Although rhegmatogenous retinal detachment (RRD) repair techniques have high anatomical reattachment rates, there may be differences in various aspects of postoperative vision-related quality of life (VRQoL).

Objective: To explore the differences in various aspects of VRQoL between pneumatic retinopexy (PnR) and pars plana vitrectomy (PPV) following RRD repair.

Design, setting, and participants: Post hoc exploratory analysis of the the Pneumatic Retinopexy vs Vitrectomy for the Management of Primary Rhegmatogenous Retinal Detachment Outcomes randomized clinical trial conducted between August 2012 and May 2017 at St Michael's Hospital, Toronto, Ontario, Canada. Patients with RRD with a single break or multiple breaks within 1 clock hour of detached retina in the superior 8 clock hours of the retina with any number, location, and size of retinal breaks or lattice degeneration in attached retina.

Main outcomes and measures: Differences in the 25-Item National Eye Institute Visual Function Questionnaire 12 subscale scores between the PnR and PPV groups at 6 months following RRD repair.

Results: A total of 160 patients were included in this analysis, with 81 patients (92%) and 79 patients (90%) in the PnR and PPV groups, respectively. The PnR group consisted of 32% women with a mean (SD) age of 60.9 (9.3) years, while the PPV group consisted of 38% women with a mean (SD) age of 60.3 (7.6) years. For the 152 patients with 6-month follow-up (75 patients in PnR [85%] and 77 patients in PPV [88%]), there was evidence for an association of PnR with superior vision-related functioning compared with PPV for several subscales. There were no differences between groups at 1 year. After adjusting for age, sex, baseline macular status, visual acuity in the nonstudy eye, and lens status, patients who underwent PnR had higher scores for distance activities (mean [SD] PnR, 88.7 [13.4]; PPV, 82.8 [17.1]; adjusted difference, 6.5; 95% CI, 1.6-11.4; P = .01), mental health (mean [SD] PnR, 84.3 [17.4]; PPV, 78.7 [21.1]; adjusted difference, 6.7; 95% CI, 0.4-13; P = .04), dependency (mean [SD] PnR, 96.1 [10.1]; PPV, 91.1 [18.6]; adjusted difference, 5.7; 95% CI, 0.6-10.8; P = .03), and peripheral vision (mean [SD] PnR, 91.6 [16.2]; PPV, 81.2 [24.4]; adjusted difference, 10.8; 95% CI, 4.3-17.4; P = .001) at 6 months.

Conclusions and relevance: These findings demonstrate that patients undergoing PnR for RRD report higher mental health scores and superior vision-related functioning scores in several subscales of the 25-Item National Eye Institute Visual Function Questionnaire during the first 6 months postoperatively compared with PPV.

Trial registration: ClinicalTrials.gov Identifier: NCT01639209.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest Disclosures: Dr Wong reported nonfinancial support from Alcon; personal fees from Allergan, Bayer, Bausch Health, and Topcon; grants and personal fees from Novartis and Roche; personal fees and nonfinancial support from Zeiss; and other support from ArcticDX outside the submitted work. Dr Kertes reported grants and personal fees from Bayer, Novartis, and Roche and grants from Allergan outside the submitted work. No other disclosures were reported.

Figures

Figure.
Figure.. Patient Flow Diagram
See this image and copyright information in PMC

Comment in

References

    1. Mitry D, Chalmers J, Anderson K, et al. . Temporal trends in retinal detachment incidence in Scotland between 1987 and 2006. Br J Ophthalmol. 2011;95(3):365-369. doi:10.1136/bjo.2009.172296 - DOI - PubMed
    1. Hillier RJ, Felfeli T, Berger AR, et al. . The pneumatic retinopexy versus vitrectomy for the management of primary rhegmatogenous retinal detachment outcomes randomized trial (PIVOT). Ophthalmology. 2019;126(4):531-539. doi:10.1016/j.ophtha.2018.11.014 - DOI - PubMed
    1. Shu I, Ishikawa H, Nishikawa H, et al. . Scleral buckling versus vitrectomy for young japanese patients with rhegmatogenous retinal detachment in the era of microincision surgery: real-world evidence from a multicentre study in Japan. Acta Ophthalmol. 2019;97(5):e736-e741. doi:10.1111/aos.14050 - DOI - PubMed
    1. Mangione CM, Lee PP, Gutierrez PR, Spritzer K, Berry S, Hays RD; National Eye Institute Visual Function Questionnaire Field Test Investigators . Development of the 25-item National Eye Institute Visual Function Questionnaire. Arch Ophthalmol. 2001;119(7):1050-1058. doi:10.1001/archopht.119.7.1050 - DOI - PubMed
    1. Mangione CM, Lee PP, Pitts J, Gutierrez P, Berry S, Hays RD; NEI-VFQ Field Test Investigators . Psychometric properties of the National Eye Institute Visual Function Questionnaire (NEI-VFQ). Arch Ophthalmol. 1998;116(11):1496-1504. doi:10.1001/archopht.116.11.1496 - DOI - PubMed

Publication types

MeSH terms

Associated data