Outcomes of modified pneumatic retinopexy with transscleral subretinal fluid drainage for primary rhegmatogenous retinal detachment

Background To evaluate the anatomic and visual outcomes of a modified pneumatic retinopexy (mPnR) technique incorporating transscleral drainage of subretinal fluid for the treatment of primary rhegmatogenous retinal detachment (RRD). Methods This retrospective, single-centre case series included 53 consecutive eyes of 53 patients with primary RRD meeting the Pneumatic Retinopexy versus Vitrectomy trial criteria. All patients underwent mPnR, which consisted of transscleral subretinal fluid drainage, intravitreal air injection, and postoperative laser photocoagulation of retinal breaks. The main outcome measures were single-surgery anatomical success rate and best-corrected visual acuity (BCVA) at 3 months postoperatively. Results The single-surgery anatomic success rate was 96.23% (51/53). Mean BCVA significantly improved from 0.10 (interquartile range [IQR],0.00-0.60) logarithm of the minimum angle of resolution (logMAR) preoperatively to 0.02 (IQR,0.00-0.20) logMAR at 3 months postoperatively (P<0.001). In the macula-off subgroup (n = 20), the anatomic success rate was 100%; BCVA improved from 0.75 (IQR,0.43–1.18) logMAR to 0.20(IQR,0.04–0.30) logMAR (P<0.001). Two eyes (3.77%) with recurrent detachment and one eye (1.89%) with a secondary macular epiretinal membrane required subsequent pars plana vitrectomy. Conclusions The mPnR technique is an effective and safe treatment for primary RRD. The procedure is efficient and minimally invasive, does not require expansile gas, and can be performed in an outpatient setting, supporting its potential for widespread adoption. Trial registration: Not applicable.