Efficacy of Pneumatic Retinopexy Preceding Pars Plana Vitrectomy in Managing Combined Retinal and Choroidal Detachment: A Retrospective Study of 64 Patients

BACKGROUND: Combined retinal and choroidal detachment (RD-CD) poses significant challenges in ophthalmic treatment, often requiring surgical intervention for optimal outcomes. The selection of the appropriate surgical procedure is crucial for ensuring visual restoration and overall eye health. This study delves into the therapeutic benefits and outcomes of two distinct surgical approaches for RD-CD: pneumatic retinopexy (PR) followed by pars plana vitrectomy (PPV) and PPV alone, in an attempt to guide optimal clinical decision-making. MATERIAL/METHODS: We retrospectively analyzed data from 64 consecutive patients diagnosed with RD-CD. They were categorized into two groups: Group A consisted of 34 patients (34 eyes) who underwent PR as an initial treatment and subsequently received PPV, while Group B, serving as a control, comprised 30 patients (30 eyes) treated solely with PPV. RESULTS: The application of PR in Group A notably accelerated intraocular pressure (IOP) increase (P<0.001) and effectively restored the CD degree (P<0.001) compared to Group B. Distinct variations were observed between the groups concerning the need for suprachoroidal drainage (P<0.001) and the duration of the vitrectomy procedure (P=0.025). However, after a 6-month follow-up period, visual acuity (VA) enhancement rates (P=0.496) and overall retinal re-attachment rates (P=0.635) showed no significant disparities between the two groups. CONCLUSIONS: Our findings highlight that initiating treatment for RD-CD patients with PR before PPV offers advantages, including a pronounced IOP increase, CD prevention, shortened surgical time, diminished necessity for suprachoroidal drainage, and overall enhancement of subsequent PPV surgical outcomes.