Steamroller versus basic technique in pneumatic retinopexy for primary rhegmatogenous retinal detachment.

PURPOSE: To compare the effectiveness and safety of the "basic" technique with those of the "steamroller" technique in pneumatic retinopexy (PR) for primary rhegmatogenous retinal detachment.

METHODS: In this prospective study, 40 eyes of 40 patients with primary rhegmatogenous retinal detachment were treated with PR by argon laser photocoagulation. PR with the steamroller technique (steamroller group) was performed randomly on 21 eyes of 21 patients, and 19 eyes of 19 patients were treated with PR with the basic technique (basic group). Main outcome measures were visual acuity, anatomical outcome, rate of proliferative vitreoretinopathy (PVR) development, and postoperative complications.

RESULTS: Mean follow-up +/- SD was 14.7 +/- 9.9 months (range, 6-48 months). Single-operation success rate for all patients was 70% (28/40 eyes). Single-operation success rate was 74% (14/19 eyes) for the basic group and 67% (14/21 eyes) for the steamroller group (P = 0.629). PVR grade C-1 developed in one eye (5%) in each group. Overall success rate, after reoperations, was 100% for each group. Preoperative logMAR (logarithm of the minimum angle of resolution) visual acuity +/- SD was 2.01 +/- 0.43 in the basic group and 1.89 +/- 0.45 in the steamroller group (P = 0.434). Postoperative logMAR visual acuity +/- SD was 0.64 +/- 0.42 in the basic group and 0.46 +/- 0.35 in the steamroller group (P = 0.152). There was no statistically significant difference between basic and steamroller groups in terms of postoperative complications (P > 0.05).

CONCLUSION: Basic and steamroller techniques appear to be equally effective and safe in PR for primary rhegmatogenous retinal detachment. The risk for PVR development seems to be similar with either technique. Further studies with a large number of patients are required for a more reliable conclusion.