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Graefe's Archive for Clinical and Experimental Ophthalmology

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29-04-2023 | Retinal Detachment | Retinal Disorders

Expansile gas concentration in primary pseudophakic retinal detachment repair, effect on intraocular pressure and outcomes; the Manchester Pseudophakic Retinal Detachment Study

Authors: George Moussa, Assad Jalil, Tsveta Ivanova, Irina-Elena Cristescu, Mariantonia Ferrara, Myrta Lippera, Kirti M. Jasani, Felipe Dhawahir-Scala, Niall Patton

Published in: Graefe's Archive for Clinical and Experimental Ophthalmology | Issue 9/2023

Abstract

Purpose

To investigate the effect of isovolumetric and expansile gas tamponade concentrations on single surgery anatomical success (SSAS) and day 1 intraocular pressure (IOPD1) following pars plana vitrectomy (PPV) for mild-moderate complexity primary pseudophakic rhegmatogenous retinal detachment (PRD).

Methods

We conducted a single-centre retrospective continuous and comparative study on eyes that had undergone small-gauge PPV using isovolumetric versus expansile gas for PRD repair between 2011 and 2020 at a single tertiary vitreoretinal centre in UK. We performed propensity score matching (PSM) using preoperative findings as covariates to account for relevant confounders. Significant risk factors such as proliferative vitreoretinopathy C or giant retinal tears were excluded.

Results

From 456 eyes, PSM analysis matched 240 eyes with 120 in each group. The median (interquartile range) follow-up was 96 (59 to 218) days. The SSAS was 229/240 (95.8%) overall; 115/120 (95.8%) and 114/120 (95.0%) in isovolumetric and expansile groups, respectively (p = 1.000). Relative to the isovolumetric group, the expansile group had lower proportion of eyes with IOP ≤ 21 mmHg (odds ratio, 95% confidence interval, 0.40 [0.23–0.68], p < 0.001); but significantly higher number of eyes with IOP ≥ 22 mmHg (2.53 [1.48–4.34], p < 0.001), ≥ 25 mmHg (2.77 [1.43–5.33], p < 0.001), ≥ 30 mmHg (2.90 [1.28–6.58], p = 0.006) and ≥ 40 mmHg (p = 0.029, isovolumetric: 0 [0%] vs expansile group: 6 [5%]). There was only one case of hypotony (≤ 5 mmHg) 1/240 (0.4%) which occurred in the expansile group.

Conclusions

Expansile gas concentration does not impact SSAS but is associated with significantly raised IOPD1 with no reduction in hypotony rates following PPV for primary PRD.

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Title: Expansile gas concentration in primary pseudophakic retinal detachment repair, effect on intraocular pressure and outcomes; the Manchester Pseudophakic Retinal Detachment Study
Authors: George Moussa
Assad Jalil
Tsveta Ivanova
Irina-Elena Cristescu
Mariantonia Ferrara
Myrta Lippera
Kirti M. Jasani
Felipe Dhawahir-Scala
Niall Patton
Publication date: 29-04-2023
Publisher: Springer Berlin Heidelberg
Keywords: Retinal Detachment
Vitrectomy
Published in: Graefe's Archive for Clinical and Experimental Ophthalmology / Issue 9/2023
Print ISSN: 0721-832X
Electronic ISSN: 1435-702X
DOI: https://doi.org/10.1007/s00417-023-06067-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Expansile gas concentration in primary pseudophakic retinal detachment repair, effect on intraocular pressure and outcomes; the Manchester Pseudophakic Retinal Detachment Study

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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