Anatomical and Functional Outcomes of Pneumatic Retinopexy for Retinal Detachment: A 2-Year Case Series

August 26, 2026 updated by: Daniel Andrés Noguera Fuertes, Clinica Oftalmologica Paredes

Anatomical and Functional Outcomes of Pneumatic Retinopexy for Rhegmatogenous Retinal Detachment Using PIVOT Criteria: A 2-Year Case Series From a Referral Center in Southwestern Colombia

The goal of this observational study is to evaluate the 2-year anatomical and functional outcomes of pneumatic retinopexy in phakic adult patients with superior rhegmatogenous retinal detachment meeting adapted PIVOT eligibility criteria. The main questions it aims to answer are to determine the primary anatomical success rate over 24 months-defined as sustained retinal reattachment without secondary vitrectomy or scleral buckling-and to evaluate long-term visual acuity outcomes and structural macular integrity measured by OCT. As a single-arm observational case series, participants undergo baseline ophthalmic evaluation (BCVA, OCT, and fundus photography), followed by a standardized outpatient procedure consisting of anterior chamber paracentesis (0.3 cc), inferotemporal intravitreal 100% C3F8 gas injection (0.7 cc), face-down positioning followed by the steam-roll maneuver, postoperative 577-nm yellow laser retinopexy with a 360° peripheral barrier upon reattachment, and protocolized follow-up evaluations on Day 1, at 3 weeks, 6 weeks, 3 months, and up to 24 months.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

Rhegmatogenous retinal detachment (RRD) is a critical ophthalmic emergency caused by full-thickness retinal breaks that permit subretinal fluid accumulation, risking irreversible photoreceptor damage. Pneumatic retinopexy (PnR) combines intravitreal expansile gas injection with laser or cryotherapy retinopexy as a minimally invasive outpatient procedure. Although the landmark PIVOT trial demonstrated the non-inferiority and functional advantages of PnR compared to vitrectomy in selected cases, long-term 2-year prospective evidence on anatomical and functional outcomes in Latin American settings remains limited.

This prospective observational study evaluated 33 phakic adult patients presenting with superior RRD who strictly met adapted PIVOT eligibility criteria at Clínica Oftalmológica Paredes in Pasto, Colombia. Preoperative assessment included a comprehensive evaluation by a retina specialist, best-corrected visual acuity (BCVA), macular OCT (AngioVue/RTVue XR), and wide-field retinal photography (Eidon FA). Before gas injection, 577-nm yellow argon laser photocoagulation was applied to any retinal breaks without associated detachment.

The standardized surgical intervention was performed under topical anesthesia and operating room aseptic conditions, beginning with an anterior chamber paracentesis extracting 0.3 cc of aqueous humor, followed by an inferotemporal injection of 0.7 cc of 100% C3F8 gas 4 mm from the limbus and compressive hemostasis. Following the injection, patients maintained a strict face-down position for one hour and, after verifying foveal reattachment and intraocular pressure, initiated the steam-roll positioning maneuver to guide the gas bubble over the break.

Within 24 to 48 hours post-injection, once retinal reattachment was achieved, complete 577-nm yellow laser photocoagulation was performed around the breaks along with a 360° peripheral laser barrier, while non-responding cases were scheduled for secondary vitrectomy within one week. Long-term follow-up of successful cases was conducted on Day 1, at 3 weeks, 6 weeks, 3 months, and up to 24 months to document primary anatomical success, tear tamponade efficacy, BCVA evolution, IS/OS junction integrity on OCT, intraocular pressure dynamics, and complications such as macular edema or epiretinal membrane formation.

Study Type

Observational

Enrollment (Actual)

33

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Colombia
    • Departamento de Nariño
      • Pasto, Departamento de Nariño, Colombia, 520002
        • Clínica Oftalmológica Paredes

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Sampling Method

Non-Probability Sample

Study Population

Phakic adult patients presenting with primary superior rhegmatogenous retinal detachment (RRD) evaluated and treated at the retina service of Clínica Oftalmológica Paredes in Pasto, Colombia, who met adapted PIVOT trial eligibility criteria.

Description

Inclusion Criteria:

  • Age 18 years or older.
  • Phakic status in the study eye.
  • Diagnosis of primary rhegmatogenous retinal detachment (RRD).
  • Single retinal break or a group of breaks extending within 1 clock hour of the upper retina (located between 8:00 and 4:00 clock hours).
  • Ability and willingness to comply with post-procedure face-down positioning, steam-roll maneuvers, and scheduled follow-up visits.

Exclusion Criteria:

  • Pseudophakic or aphakic status.
  • Retinal breaks located in the inferior 4 clock hours (between 4:00 and 8:00 clock hours).
  • Multiple retinal breaks spanning more than 1 clock hour.
  • Presence of proliferative vitreoretinopathy (PVR) grade C or D.
  • Media opacities obstructing adequate visualization of the fundus or preventing effective laser photocoagulation (e.g., severe vitreous hemorrhage or advanced cataract).
  • Uncontrolled baseline intraocular pressure or pre-existing advanced glaucoma.
  • History of prior vitreoretinal surgery in the study eye.
  • Physical, mental, or geographic inability to maintain strict post-procedure positioning or fulfill protocol requirements.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Cohorts and Interventions

Group / Cohort
Intervention / Treatment
Pneumatic Retinopexy (PnR) Cohort
Phakic adult patients presenting with primary superior rhegmatogenous retinal detachment (RRD) meeting adapted PIVOT eligibility criteria. All participants underwent standardized pneumatic retinopexy, including anterior chamber paracentesis (0.3 cc), inferotemporal intravitreal 100% C3F8 gas injection (0.7 cc), initial face-down and steam-roll positioning, and postoperative 577-nm yellow argon laser retinopexy with a 360-degree peripheral barrier.
Procedure: Pneumatic Retinopexy
Standardized pneumatic retinopexy protocol including pre-gas 577-nm yellow argon laser to non-detached breaks (if applicable), anterior chamber paracentesis (0.3 cc), inferotemporal intravitreal injection of 100% C3F8 gas (0.7 cc), 1 hour of face-down positioning followed by steam-roll maneuver, and postoperative 577-nm yellow argon laser retinopexy with a 360-degree peripheral barrier once retinal reattachment is achieved.
Other Names:
  • PnR
  • Pneumoretinopexia
  • C3F8 gas injection and laser retinopexy

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Primary Anatomical Success Rate
Time Frame: 24 months
Proportion of patients achieving sustained retinal reattachment following initial pneumatic retinopexy without requiring secondary surgical interventions (such as pars plana vitrectomy or scleral buckling).
24 months

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Clinica Oftalmologica Paredes

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

June 6, 2020

Primary Completion (Actual)

November 11, 2023

Study Completion (Actual)

April 7, 2026

Study Registration Dates

First Submitted

August 26, 2026

First Submitted That Met QC Criteria

August 26, 2026

First Posted (Actual)

August 31, 2026

Study Record Updates

Last Update Posted (Actual)

August 31, 2026

Last Update Submitted That Met QC Criteria

August 26, 2026

Last Verified

August 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • PT-CO40

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

Individual participant data will not be publicly shared in an open data repository. However, de-identified participant data and protocol details can be made available by the corresponding author upon reasonable academic request.

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

Subscribe