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Abstract：
OBJECTIVE: To evaluate the efficacy of pneumatic retinopexy (PR) in patients undergoing PR as primary treatment for rhegmatogenous retinal detachment (RRD) and analyze the factors associated with success and failure in the studied population.
METHODS: A retrospective chart review was done of patients with RRD treated with PR as primary management method treated at New York Eye and Ear Infirmary of Mount Sinai between January 2017 and December 2021. Primary outcome measured success or failure of PR. Secondary outcome measured best corrected visual acuity (BCVA) after PR. A separate risk analysis was done to identify and stratify risks associated with success and failure of PR.
RESULTS: A total of 179 eyes from 179 patients were included for final analysis. The 83 patients (46.37%) achieved anatomical reattachment of the retina after primary PR with no need for additional surgery. The 96 patients (53.63%) had a failed primary PR and required a PPV and 6 of them required pars plana vitrectomy (PPV) with scleral buckle (SB). In total, 19 cases (10.61%) were done as temporizing pneumatics, 18 (94.74%) underwent PPV, and 1 (5.26%) did not require further intervention. The visual acuities at postoperative month 1 (POM1) for patients who underwent primary PR successfully and for those that underwent PPV after, were 0.58 (20/80) and 1.03 (20/200) respectively. Patients who met Pneumatic Retinopexy Versus Vitrectomy for the Management of Primary Rhegmatogenous Retinal Detachment Outcomes Randomized Trial (PIVOT) criteria had a statistically significant decreased risk of primary PR failing (hazard ratio 0.29, P=0.00). Majority of missed or new breaks were found superotemporally.
CONCLUSIONS: PR is a good treatment option for treating RRDs in patients that meet PIVOT criteria and can be conducted as a temporizing measure. PIVOT criteria and fovea on status decrease the risk of PR failure.
METHODS: A retrospective chart review was done of patients with RRD treated with PR as primary management method treated at New York Eye and Ear Infirmary of Mount Sinai between January 2017 and December 2021. Primary outcome measured success or failure of PR. Secondary outcome measured best corrected visual acuity (BCVA) after PR. A separate risk analysis was done to identify and stratify risks associated with success and failure of PR.
RESULTS: A total of 179 eyes from 179 patients were included for final analysis. The 83 patients (46.37%) achieved anatomical reattachment of the retina after primary PR with no need for additional surgery. The 96 patients (53.63%) had a failed primary PR and required a PPV and 6 of them required pars plana vitrectomy (PPV) with scleral buckle (SB). In total, 19 cases (10.61%) were done as temporizing pneumatics, 18 (94.74%) underwent PPV, and 1 (5.26%) did not require further intervention. The visual acuities at postoperative month 1 (POM1) for patients who underwent primary PR successfully and for those that underwent PPV after, were 0.58 (20/80) and 1.03 (20/200) respectively. Patients who met Pneumatic Retinopexy Versus Vitrectomy for the Management of Primary Rhegmatogenous Retinal Detachment Outcomes Randomized Trial (PIVOT) criteria had a statistically significant decreased risk of primary PR failing (hazard ratio 0.29, P=0.00). Majority of missed or new breaks were found superotemporally.
CONCLUSIONS: PR is a good treatment option for treating RRDs in patients that meet PIVOT criteria and can be conducted as a temporizing measure. PIVOT criteria and fovea on status decrease the risk of PR failure.
摘要：
目的：评估气压式视网膜固定术（PR）在接受PR作为孔源性视网膜脱离（RRD）的主要治疗方法的患者中的疗效，并分析研究人群中与成功和失败相关的因素。
方法：对2017年1月至2021年12月在西奈山纽约眼耳医院接受PR治疗的RRD患者进行回顾性分析。主要结果衡量PR的成功或失败。次要结果测量PR后的最佳矫正视力（BCVA）。进行了单独的风险分析，以识别和分层与PR成功和失败相关的风险。
结果：总共179眼的179例患者被纳入最终分析。83例患者（46.37％）在初次PR后实现了视网膜的解剖重新连接，无需额外的手术。96例患者（53.63％）的原发性PR失败，需要PPV，其中6例需要巩膜扣（SB）的平坦部玻璃体切除术（PPV）。总的来说,19例（10.61%）为临时气动，18例（94.74%）接受PPV，1(5.26%)不需要进一步干预.术后1个月视力（POM1）的患者谁接受了原发性PR成功和那些接受PPV后，分别为0.58（20/80）和1.03（20/200）。符合气动视网膜固定术与玻璃体切除术治疗原发性孔源性视网膜脱离结果随机试验(PIVOT)标准的患者原发性PR失败的风险显著降低(风险比0.29,P=0.00)。大多数错过的或新的突破都是超临时发现的。
结论：PR是治疗符合PIVOT标准的RRD患者的良好治疗选择，可以作为一种临时措施进行。PIVOT标准和中央凹状态可降低PR失败的风险。
方法：对2017年1月至2021年12月在西奈山纽约眼耳医院接受PR治疗的RRD患者进行回顾性分析。主要结果衡量PR的成功或失败。次要结果测量PR后的最佳矫正视力（BCVA）。进行了单独的风险分析，以识别和分层与PR成功和失败相关的风险。
结果：总共179眼的179例患者被纳入最终分析。83例患者（46.37％）在初次PR后实现了视网膜的解剖重新连接，无需额外的手术。96例患者（53.63％）的原发性PR失败，需要PPV，其中6例需要巩膜扣（SB）的平坦部玻璃体切除术（PPV）。总的来说,19例（10.61%）为临时气动，18例（94.74%）接受PPV，1(5.26%)不需要进一步干预.术后1个月视力（POM1）的患者谁接受了原发性PR成功和那些接受PPV后，分别为0.58（20/80）和1.03（20/200）。符合气动视网膜固定术与玻璃体切除术治疗原发性孔源性视网膜脱离结果随机试验(PIVOT)标准的患者原发性PR失败的风险显著降低(风险比0.29,P=0.00)。大多数错过的或新的突破都是超临时发现的。
结论：PR是治疗符合PIVOT标准的RRD患者的良好治疗选择，可以作为一种临时措施进行。PIVOT标准和中央凹状态可降低PR失败的风险。
