Baseline characteristics of rhegmatogenous retinal detachments meeting the PIVOT trial criteria in an eye referral center in Colombia: case series
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Introduction Rhegmatogenous retinal detachment (RRD) management continues to evolve with techniques such as scleral buckle, pars plana vitrectomy, and pneumatic retinopexy (PR). PR, a less invasive procedure, may offer advantages in resource-constrained settings. This case series aims to describe baseline characteristics and PR outcomes in patients eligible for the PIVOT trial at a Colombian tertiary center. Methods Retrospective case series study (January 2021 - April 2024) at a single center in Barranquilla, Colombia, included 143 (25.40%) of 563 consecutive RRD cases meeting PIVOT criteria (single superior break ≤ 1 clock hour in detached retina; any breaks/lattice in attached retina). Exclusion criteria included inferior breaks, media opacity, PVR ≥ B, prior detachment/PPV, age < 18, incapacity, or inability to posture. Retinal reattachment status was recorded at 3 months. The primary outcome was the single-operation success (SOS) rate of PR, defined as complete retinal reattachment at 3 months with one procedure (allowing additional gas within 21 days). Descriptive statistics, Chi-square, t-tests, and Mann-Whitney U tests were used for analysis (p value 0.05 significance). Results Of 563 RRD cases, 143 (25.4%) met PIVOT criteria. Exclusions primarily involved inferior breaks (32.6%) or PVR ≥ B (27.6%). Among 105 PIVOT-eligible patients receiving PR, SOS rate was 85.7%. Baseline factors (age, sex, lens, macular status) were similar between success (n = 90) and failure (n = 15) groups (p > 0.05). Detachments > 2 quadrants associated with failure (p = 0.045; use caution). Symptom-to-procedure time similar. Conclusion Approximately 25% of primary RRD patients met PIVOT criteria, indicating significant PR caseload potential. The high observed PR SOS rate supports its feasibility and effectiveness for appropriately selected patients in resource-constrained settings like Colombia.
