Pneumatic retinopexy versus vitrectomy for the management of primary rhegmatogenous retinal detachment outcomes trial (PIVOT): 1-year

Session Details

Session Title: Free Paper Session 6: Vitreoretinal Surgery II

Session Date/Time: Thursday 07/09/2017 | 14:30-16:00

Paper Time: 14:42

Venue: Room 111

First Author: : R.Muni CANADA

Co Author(s): :    R. Hillier   L. Giavedoni   D. Wong   A. Berger   F. Altomare   R. Kohly              

Abstract Details

Purpose:

Contemporary practice patterns for the management of rhegmatogenous retinal detachment (RRD) vary markedly among vitreoretinal surgeons, largely based on prior experience, local culture, geography and age. We report the results of the first prospective randomised controlled trial to compare long-term outcomes of RRD repair, including anatomical success, functional success, complications, and impact on quality of life, for patients undergoing pneumatic retinopexy (PnR) versus pars plana vitrectomy (PPV).

Setting:

Tertiary care centre in an academic hospital.

Methods:

Prospective randomised controlled trial conducted from August 2012 to May 2017. RRDs irrespective of lens status presenting with a single retinal break, or group of breaks no larger than one clock hour, above the 8 and 4 o’clock meridians were included. Patients with any retinal breaks at any location in attached retina were included. Macula-on and -off RRDs were assigned to each group by stratified randomisation and treated within 24 hours and 72 hours, respectively. The primary outcome measure was 1-year ETDRS visual acuity. Secondary outcomes included primary reattachment rates, subjective visual function (VFQ-25 questionnaire), health related quality of life (SF36 questionnaire) and complication rates.

Results:

One-hundred and seventy-six eyes of 176 patients were enrolled in the study. The last patient was enrolled in May 2016. Upon completion of the last patient 1-year study visit in May 2017, 1-year ETDRS visual acuity data will be compared between the PnR and PPV groups and reported at the 2017 EURETINA Congress. Primary reattachment and complication rates will also be reported for both patient groups. An a priori planned sub-group analysis will be performed to determine results stratified by macular status.

Conclusions:

We report the 1-year anatomical and functional outcomes of this randomised controlled trial comparing PnR versus PPV in the management of primary RRD. The results of this study will assist vitreoretinal surgeons in making evidence-based management decisions for their patients with this condition.

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