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Pneumatic retinopexy considered first-line treatment for primary rhegmatogenous retinal detachment
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BOSTON — Pneumatic retinopexy as first-line treatment in patients with rhegmatogenous retinal detachment yielded better visual results and less morbidity than vitrectomy, according to 1-year results of the PIVOT trial.
“Pneumatic retinopexy as per PIVOT trial criteria should be considered and offered to patients before vitrectomy in phakic and pseudophakic patients,” Rajeev H. Muni, MD, MSC, FRCS(C), said at the American Society of Retina Specialists meeting.
In the trial, 176 eyes of 176 patients were randomized to either pneumatic retinopexy or vitrectomy. Operations were performed by five vitreoretinal surgeons at a single practice. Regarding visual outcomes at 1 year, patients in the pneumatic arm had a statistically significantly better mean ETDRS score of 4.93 letters than patients in the vitrectomy group (P = .0244), with the significant difference being maintained over time.
A subgroup analysis to determine whether there was a difference in results in phakic and pseudophakic eyes was also done.
“There was no difference,” Muni said. “The benefit of pneumatic persisted, whether they were phakic or pseudophakic, whether they were macula on or macula off.”
Anatomically, 99% of all patients in both groups had final retinal reattachment, he said. – by Patricia Nale, ELS
Reference:
Muni RH. Randomized trial comparing pneumatic retinopexy vs. vitrectomy in the management of primary rhegmatogenous retinal detachment (PIVOT): 1-year results. Presented at: American Society of Retina Specialists 35th Annual Meeting, Aug. 11-15, 2017; Boston.
Disclosure: Muni reports no relevant financial disclosures.