Pneumatic Retinopexy Versus Vitrectomy for Retinal Detachment

A Randomised Controlled Trial Comparing Pneumatic Retinopexy Versus Vitrectomy for the Management of Primary Retinal Detachment; Anatomical Success, Functional Success and Impact on Patient Quality of Life

The purpose of this research study is to compare the outcomes of pneumatic retinopexy with the outcomes of vitrectomy (with or without scleral buckle) for the management of retinal detachment, in terms of anatomical success, functional success and impact on patient quality of life.

Rhegmatogenous retinal detachment (RRD)is an acute, sight threatening condition, with an incidence of approximately 10 per 100,000 population. Both of the treatments under investigation are widely used and accepted by vitreoretinal surgeons, but randomised, prospective comparison of the two techniques has not been reported in the scientific literature to date. Currently, the management decisions surrounding primary retinal detachment are grounded on a weak evidence base. The findings of this study will allow vitreoretinal surgeons and their patients to select the most appropriate intervention for that individual, in an informed and holistic manner.

Inclusion Criteria:

• Patients presenting with acute rhegmatogenous retinal detachment
• Single retinal break OR group of breaks no larger than one clock hour (30°)
• All break/s in detached retina between 8-4 o'clock
• No significant proliferative vitreoretinopathy

Exclusion Criteria:

• Inferior breaks in detached retina
• Inability to read English language
• Age < 18 years
• Mental incapacity
• Previous vitrectomy (index eye)
• Previous retinal detachment (index eye)
• Inability to maintain the post-operative posturing
• Inability to carry out detailed examination of peripheral retina due to media opacity