Pneumatic Retinopexy Experience and Outcomes of Vitreoretinal Fellows in the United States: A Multicenter Study

Purpose To evaluate the outcomes of patients undergoing pneumatic retinopexy (PR) performed by vitreoretinal fellows at 6 academic centers in the United States. Design Retrospective, multicenter, consecutive case series. Participants Four hundred eighty-three patients with primary retinal detachments who underwent PR by 49 vitreoretinal fellows from 6 United States training sites between 2002 and 2016. Methods We reviewed medical records of patients and recorded baseline clinical characteristics (age, gender, baseline visual acuity, lens status, presence of lattice degeneration, presence of vitreous hemorrhage, location of retinal breaks, macular status, and size of detachment), visual and anatomic outcomes at 3 months after PR, as well as training level and PR experience of the fellow at the time of the procedure. Main Outcome Measures Single-procedure anatomic success and visual acuity at 3 months of follow-up and association with clinical and training-related factors. Results Vitreoretinal fellows performed a variable number of PR procedures, with a median of 7 per fellow (range, 1–24). Single-procedure anatomic success was 66.8%, and mean visual outcome was 0.43 logarithm of the minimum angle of resolution (Snellen equivalent, 20/54) at 3 months. Factors that were associated independently with single-procedure success included phakic lens status ( P  = 0.01), smaller size of retinal detachment ( P  = 0.02), and the fellow’s procedure experience ( P  = 0.01). The only factor associated with worse visual outcome was baseline visual acuity ( P Conclusions Vitreoretinal fellows perform variably few PR procedures but have outcomes comparable with those reported by experienced specialists. Procedure experience of individual fellows may impact anatomic outcomes.