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Pneumatic Retinopexy vs Vitrectomy for the Management of Primary Rhegmatogenous Retinal Detachment Outcomes Randomized Trial (PIVOT)

April 1, 2019

Clinical Trial

The Pneumatic Retinopexy versus Vitrectomy for the Management of Primary Rhegmatogenous Retinal Detachment Outcomes Randomized Trial (PIVOT).

Hillier RJ, Felfeli T, Berger AR, Wong DT, Altomare F, Dai D, Giavedoni LR, Kertes PJ, Kohly RP, Muni RH.

Ophthalmology. 2019 Apr;126(4):531-539.
Full text | Metrics.

Main finding: In patient fulfilling study criteriae, pneumatic retinopexy offers superior visual acuity, less vertical metamorphopsia, and reduced morbidity when compared with pars plana vitrectomy in primary rhegmatogenous retinal detachment.

 

  • Purpose: To compare outcomes of pneumatic retinopexy versus pars plana vitrectomy for the management of primary rhegmatogenous retinal detachment.
  • Study type: Randomized controlled Trial
  • Condition: Rhegmatogenous retinal detachment.

Participants: Rhegmatogenous retinal detachment.
-a single retinal break or a group of breaks in detached retina within 1 clock hour above the 8- and 4-o’clock meridian with any number, location and size of retinal breaks or lattice degeneration in attached retina.

 

  • n=176

 

Intervention:

 

Group 1: pneumatic retinopexy
Group 2: pars plana vitrectomy

Time period Pneumatic retinopexy Pars plana vitrectomy Difference
Visual acuity 3 months 78.4 68.5
6 months 79.2 68.6
12 months 79.9 68.6 +4.9 (PnR superior)
Vertical metamorphopsia scores 12 months 0.14 0.28 PnR superior
Primary anatomic success 12 months 80.8% 93.2%
Secondary anatomic success 12 months 98.7% 98.6%
Requirement of cataract surgery before 12 months 16% 75%

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