Akiyama Kunihiko, Matsuki Takaaki, Watanabe Ken, Pecaku Aurora, Naidu Sumana, Muni Rajeev H
Department of Ophthalmology, NHO Tokyo Medical Center, 2-5-1, Higashigaoka, Meguro-ku, Tokyo, 152-8902, Japan.
Division of Vision Research, National Institute of Sensory Organs, NHO Tokyo Medical Center, Tokyo, Japan.
Jpn J Ophthalmol. 2025 Jul 25. doi: 10.1007/s10384-025-01241-z.
To propose an implementation model for pneumatic retinopexy (PnR) in a region where PnR is performed infrequently, and to assess its impact on treatment of rhegmatogenous retinal detachment (RRD).
Retrospective case series.
We reviewed 222 consecutive eyes with primary RRD treated from July 2017 to September 2023 at a tertiary care center in Japan. The treatment methods utilized included pars plana vitrectomy (PPV), scleral buckling (SB) and PnR. The surgeon learned PnR through social media. Primary anatomic reattachment rate (PARR) and visual acuity outcomes were compared between the pre-PnR (prior to the implementation; 110 eyes) and post-PnR (after the implementation; 112 eyes) periods, as well as between PnR and PPV in the post-PnR period. PARR for PnR was also evaluated based on RRD characteristics and gas injection frequency.
In the post-PnR period PnR was performed in 53.6% (60/112)of cases. The PARR was similar in the pre-PnR (97.3%) and post-PnR (93.8%) periods (P=.33). Visual outcomes were similar both across periods and between PnR and PPV at 3, 6 and 12 month post-operatively. The PARR for PnR was 88.3% overall, 90.5% in eyes meeting the Primary Rhegmatogenous Retinal Detachment Outcomes Randomized Trial (PIVOT) criteria, 93.3% in eyes with a single break and 100% in eyes with a single break meeting PIVOT criteria. Eyes with a single gas injection had higher PARR than eyes requiring an additional gas injection (93.5% vs. 71.4%).
Remote-learning utilizing social media effectively enabled PnR implementation with favorable anatomic and functional outcomes in a real-world setting in Japan.
在气性视网膜固定术（PnR）开展较少的地区提出一种PnR实施模式，并评估其对孔源性视网膜脱离（RRD）治疗的影响。
回顾性病例系列研究。
我们回顾了2017年7月至2023年9月期间在日本一家三级医疗中心接受治疗的222例连续的原发性RRD患眼。所采用的治疗方法包括玻璃体切除术（PPV）、巩膜扣带术（SB）和PnR。手术医生通过社交媒体学习PnR。比较了PnR实施前（实施前；110只眼）和实施后（实施后；112只眼）两个阶段的原发性解剖复位率（PARR）和视力结果，以及实施后阶段PnR与PPV之间的情况。还根据RRD特征和气体注入频率评估了PnR的PARR。
在实施后阶段，53.6%（60/112）的病例采用了PnR。PnR实施前（97.3%）和实施后（93.8%）两个阶段的PARR相似（P = 0.33）。术后3、6和12个月时，各阶段以及PnR与PPV之间的视力结果相似。PnR的总体PARR为88.3%，符合原发性孔源性视网膜脱离结局随机试验（PIVOT）标准的患眼中为90.5%，单个裂孔患眼中为93.3%，符合PIVOT标准的单个裂孔患眼中为100%。单次注入气体的患眼PARR高于需要额外注入气体的患眼（93.5%对71.4%）。
在日本的实际临床环境中，利用社交媒体进行远程学习有效地实现了PnR的实施，并取得了良好的解剖和功能效果。
