Our Summary

This study compares two treatments for a condition called rhegmatogenous retinal detachment, where the retina (the layer at the back of the eye that processes light) separates from the rest of the eye. The two treatments are called pneumatic retinopexy (PnR) and pars plana vitrectomy (PPV).

The researchers looked at six previous studies, which included a total of 1,061 patients, to see how effective each treatment was. They measured success by looking at the patients’ visual acuity (how well they could see), whether the retina was successfully reattached, and any complications that occurred.

The results showed no significant difference in visual acuity between the two treatments. However, the odds of the retina being successfully reattached were significantly higher with PPV than with PnR. There were no significant differences in final anatomical success (whether the eye was ultimately structured correctly) or the development of cataracts. However, other complications, including new retinal tears and a condition called proliferative vitreoretinopathy (where scar tissue forms on the retina), were reported more frequently in the PnR group.

In conclusion, PPV seems to be a better treatment for rhegmatogenous retinal detachment, as it has a higher rate of successful reattachment and comparable rates of complications and visual acuity outcomes compared to PnR.

FAQs

  1. What is the primary outcome of the study comparing pneumatic retinopexy (PnR) and pars plana vitrectomy (PPV) for rhegmatogenous retinal detachment (RRD)?
  2. Are there any significant differences in the rates of complications between PnR and PPV treatments for RRD?
  3. Which treatment has a higher rate of primary reattachment for RRD, PnR or PPV?

Doctor’s Tip

A doctor might tell a patient that while pneumatic retinopexy (PnR) and pars plana vitrectomy (PPV) have similar visual acuity outcomes, PPV has a higher rate of primary reattachment for treating rhegmatogenous retinal detachment. They would also mention that complications such as retinal tears and postoperative proliferative vitreoretinopathy were more frequently reported in the PnR group.

Suitable For

Patients with rhegmatogenous retinal detachment (RRD) are typically recommended vitrectomy, especially those who have failed other less invasive treatments such as pneumatic retinopexy (PnR). Patients with complicated retinal detachments, severe proliferative vitreoretinopathy, or other factors that may complicate surgical repair may also be recommended for vitrectomy. Additionally, patients with diabetic retinopathy, macular holes, epiretinal membranes, or other vitreoretinal disorders may also benefit from vitrectomy surgery. Ultimately, the decision to recommend vitrectomy will depend on the specific circumstances of each individual patient and should be made in consultation with a retinal specialist.

Timeline

Before vitrectomy:

  1. Patient is diagnosed with rhegmatogenous retinal detachment (RRD) through a comprehensive eye examination.
  2. Patient undergoes discussions with their ophthalmologist about treatment options, including pneumatic retinopexy (PnR) and pars plana vitrectomy (PPV).
  3. Patient may undergo preoperative testing and evaluation to determine the best course of treatment.

After vitrectomy:

  1. Patient undergoes the vitrectomy procedure, which involves removing the vitreous gel from the eye and repairing the retinal detachment.
  2. Postoperatively, the patient may experience some discomfort, redness, and blurred vision in the affected eye.
  3. Follow-up appointments with the ophthalmologist are scheduled to monitor the healing process and assess visual acuity.
  4. Over time, the patient’s vision may improve as the eye heals and the retina reattaches.
  5. Complications such as cataracts, retinal tears, and postoperative proliferative vitreoretinopathy may occur and are monitored and managed by the ophthalmologist.
  6. Ultimately, the patient’s visual acuity and overall eye health are assessed to determine the success of the vitrectomy procedure in treating RRD.

What to Ask Your Doctor

Some questions a patient may consider asking their doctor about vitrectomy include:

  • What are the potential risks and complications associated with vitrectomy?
  • How long is the recovery period after vitrectomy surgery?
  • Will I need to undergo any additional procedures or treatments after vitrectomy?
  • What are the expected outcomes in terms of visual acuity and reattachment of the retina?
  • Are there any alternative treatment options to vitrectomy that I should consider?
  • How experienced are you in performing vitrectomy procedures?
  • What can I do to prepare for the surgery and improve my chances of a successful outcome?
  • How soon after the surgery can I expect to see improvements in my vision?
  • Will I need to follow any specific post-operative care instructions or attend follow-up appointments?
  • Are there any long-term effects or complications I should be aware of following vitrectomy surgery?

Reference

Authors: Karam M, Alsaif A, Kahlar N, Hayre A, Vyas N, Ekitok SR, Gan WL, Al-Hity A. Journal: Ophthalmic Surg Lasers Imaging Retina. 2023 Jun;54(6):354-361. doi: 10.3928/23258160-20230508-03. Epub 2023 Jan 5. PMID: 37222541