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Abstract：
BACKGROUND: To report real-world outcomes of patients with primary Reghmatogenous Retinal Detachment (RRD) treated with Pneumatic Retinopexy (PnR) according to the indications of the Pneumatic Retinopexy versus Vitrectomy for management of Primary Rhegmatogenous Retinal Detachment Outcomes Randomized Trial (PIVOT) trial.
METHODS: Multicenter, retrospective study. Patients treated with PnR for RRD between 2021 and 2023 and a follow-up of at least 6 months were included. Single-procedure anatomical success, final anatomical success, complications, causes of failures, best corrected visual acuity (BCVA) after surgery, and the vision-related quality of life using the 25-Item National Eye Institute Visual Function Questionnaire (NEI VFQ-25) were reported.
RESULTS: A total of 76 eyes of 76 patients were included. Mean age was 60 ± 8.1 years. Primary anatomic reattachment was achieved by 84.3% of patients and final anatomical reattachment after pars plana vitrectomy was obtained in 100% of patients. BCVA improved from 0.32 (20/40) to 0.04 (20/20) logMar (p < 0.001) at 6 months. The main cause of failure was related to the presence of additional (likely missed) retinal breaks (66.6% of cases). Also, primary PnR failure was more frequent in eyes of patients with older age, macular involvement, worse baseline BCVA, greater extent of the RRD, and increased duration from diagnosis to treatment. Overall, the mean NEI-VFQ 25 composite score was 93.9% ± 6.4 at 6 months.
CONCLUSIONS: The criteria of the PIVOT trial can be applied to real-world scenarios in the decision-making process for the treatment of primary RRD, with excellent anatomical and functional outcomes.
METHODS: Multicenter, retrospective study. Patients treated with PnR for RRD between 2021 and 2023 and a follow-up of at least 6 months were included. Single-procedure anatomical success, final anatomical success, complications, causes of failures, best corrected visual acuity (BCVA) after surgery, and the vision-related quality of life using the 25-Item National Eye Institute Visual Function Questionnaire (NEI VFQ-25) were reported.
RESULTS: A total of 76 eyes of 76 patients were included. Mean age was 60 ± 8.1 years. Primary anatomic reattachment was achieved by 84.3% of patients and final anatomical reattachment after pars plana vitrectomy was obtained in 100% of patients. BCVA improved from 0.32 (20/40) to 0.04 (20/20) logMar (p < 0.001) at 6 months. The main cause of failure was related to the presence of additional (likely missed) retinal breaks (66.6% of cases). Also, primary PnR failure was more frequent in eyes of patients with older age, macular involvement, worse baseline BCVA, greater extent of the RRD, and increased duration from diagnosis to treatment. Overall, the mean NEI-VFQ 25 composite score was 93.9% ± 6.4 at 6 months.
CONCLUSIONS: The criteria of the PIVOT trial can be applied to real-world scenarios in the decision-making process for the treatment of primary RRD, with excellent anatomical and functional outcomes.
摘要：
背景：根据气动视网膜固定术与玻璃体切除术治疗原发性风源性视网膜脱离结局的适应症，报告使用气动视网膜固定术（PnR）治疗原发性视网膜脱离（RRD）的患者的实际结果随机试验（PIVOT）。
方法：多中心，回顾性研究。纳入2021年至2023年间接受PnR治疗RRD的患者以及至少6个月的随访。单程序解剖成功，最终的解剖学成功，并发症,失败的原因,手术后最佳矫正视力（BCVA），报告了使用25项国家眼科研究所视觉功能问卷（NEIVFQ-25）的视觉相关生活质量。
结果：共纳入76例患者的76只眼。平均年龄为60±8.1岁。84.3％的患者实现了初次解剖复位，并且在100％的患者中获得了平坦部玻璃体切除术后的最终解剖复位。在6个月时，BCVA从0.32（20/40）提高到0.04（20/20）logMar（p<0.001）。失败的主要原因与存在额外的（可能错过的）视网膜破裂有关（占病例的66.6％）。此外，原发性PnR失败在年龄较大的患者眼中更为常见，黄斑受累,基线BCVA较差，RRD的范围更大，从诊断到治疗的持续时间增加。总的来说,6个月时平均NEI-VFQ25综合评分为93.9%±6.4.
结论：PIVOT试验的标准可应用于原发性RRD治疗决策过程中的实际情况，具有出色的解剖和功能结果。
方法：多中心，回顾性研究。纳入2021年至2023年间接受PnR治疗RRD的患者以及至少6个月的随访。单程序解剖成功，最终的解剖学成功，并发症,失败的原因,手术后最佳矫正视力（BCVA），报告了使用25项国家眼科研究所视觉功能问卷（NEIVFQ-25）的视觉相关生活质量。
结果：共纳入76例患者的76只眼。平均年龄为60±8.1岁。84.3％的患者实现了初次解剖复位，并且在100％的患者中获得了平坦部玻璃体切除术后的最终解剖复位。在6个月时，BCVA从0.32（20/40）提高到0.04（20/20）logMar（p<0.001）。失败的主要原因与存在额外的（可能错过的）视网膜破裂有关（占病例的66.6％）。此外，原发性PnR失败在年龄较大的患者眼中更为常见，黄斑受累,基线BCVA较差，RRD的范围更大，从诊断到治疗的持续时间增加。总的来说,6个月时平均NEI-VFQ25综合评分为93.9%±6.4.
结论：PIVOT试验的标准可应用于原发性RRD治疗决策过程中的实际情况，具有出色的解剖和功能结果。
