Pneumatic Retinopexy for Rhegmatogenous Retinal Detachment Outcomes: IRIS® Registry (Intelligent Research in Sight) Analysis

Abstract

Purpose: To determine treatment patterns and outcomes of pneumatic retinopexy (PnR) for rhegmatogenous retinal detachments (RRDs).

Design: Retrospective cohort analysis using IRIS® Registry (Intelligent Research in Sight) database.

Participants: Patients with RRD treated by PnR from 2013 to 2022.

Methods: Cases were identified using International Classification of Diseases, Ninth and Tenth Revisions, diagnostic codes. Surgical procedures were identified using Current Procedural Terminology codes for type of RRD repair. Baseline demographic information included age, sex, race and ethnicity, geographic region, smoking status, and health insurance type.

Main outcome measures: Primary outcomes for PnR included single-operation success (SOS) and single-operation failure (SOF), change in visual acuity at 9 to 12 months, rates of complications, rates of secondary procedure after SOF, and outcome by phakic status.

Results: A total of 13 302 unique eyes were analyzed (median age, 64 years; 61.56% male). Overall SOS for primary PnR was 59.82%. The mean best-corrected visual acuity at 9 to 12 months after PnR was logarithm of the minimum angle of resolution 0.44 (95% confidence interval, 0.42-0.46) for SOF eyes, compared with 0.23 (95% confidence interval, 0.22-0.25) for SOS eyes (P < 0.001). Complications of PR included vitreous hemorrhage (9.1%), epiretinal membrane (45.17%), proliferative vitreoretinopathy (0.98%), and endophthalmitis (0.14%). Of the 40.18% of eyes with SOF, 81% required either secondary PnR, scleral buckle, vitrectomy, or complex detachment repair, whereas the remaining eyes required more than one of these secondary procedures. Single-operation success for phakic eyes was 64.50% versus 53.93% for pseudophakic eyes (P < 0.001).

Conclusions: IRIS Registry data reveal clinical outcomes and utilization patterns of PnR for RRD. Overall SOS for primary PnR was 59.82%, which is lower than other cited rates in the literature. Pseudophakic eyes were more likely to fail primary PnR. It is important to counsel patients on risks of the procedure when obtaining informed consent.

Financial disclosure(s): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

Keywords: Pneumatic retinopexy; Registry; Rhegmatogenous retinal detachment.