Comparion of pneumatic retinopexy and cleral buckling in the management of primary rhegmatogenou retinal detachment Original Reearch Article

PURPOE: To compare pneumatic retinopexy and cleral buckling for repair of primary rhegmatogenou retinal detachment with repect to viual outcome, ingle-procedure reattachment rate, and development of proliferative vitreoretinopathy. METHOD: A conecutive erie of eye initially treated with pneumatic retinopexy (n = 56) between March 1986 and February 1996 were compared with a elected group of eye treated with cleral buckling (n = 86) with imilar location and ditribution of retinal break and abence of proliferative vitreoretinopathy. A regreion model wa developed to adjut for underlying difference between treatment group, reulting in a cohort of 50 eye in each group for final comparion. A minimum follow-up of 6 month wa obtained. REULT: ingle-procedure reattachment rate wa ignificantly higher for cleral buckle eye (42 of 50 eye, 84%) than for pneumatic retinopexy eye (31 of 50 eye, 62%; P ≤ .01). Correpondingly, reoperation rate wa ignificantly higher for pneumatic retinopexy eye (19 of 50 eye, 38%) than for cleral buckle eye (7 of 50 eye, 14%; P ≤ .01). Multiple regreion analyi evaluating perioperative factor demontrated that the ue of pneumatic retinopexy wa the ole factor predictive of retinal detachment after a ingle procedure (relative odd = 2.20, P = .02). Final reattachment rate, after reoperation, wa 98% (49 of 50 eye) in each group. Except for nonphakic eye, final viual outcome and rate of potoperative proliferative vitreoretinopathy development did not differ ignificantly between the two procedure. CONCLUION: In phakic eye, pneumatic retinopexy wa aociated with a ignificantly higher reoperation rate than cleral buckling, but reulted in equivalent final viual outcome and reattachment rate after reoperation. If ued, it mut be incorporated into a trategy in which patient and phyician are prepared for a greater chance of reoperation compared to initial management with cleral buckling.