Montgomery and informed consent during Covid-19: Pneumatic retinopexy versus pars plana vitrectomy or scleral buckling for retinal detachment repair

Med Leg J. 2021 Jun;89(2):102-105. doi: 10.1177/0025817220984009. Epub 2021 Mar 10.

Abstract

Recent reports suggest that the use of an outpatient-based procedure (pneumatic retinopexy, PR) for retinal detachment repair should be encouraged within the UK, especially in light of Covid-19 and possible restrictions/competing demands on access to operating theatres. It is therefore essential that patients receive comprehensive information about the risks and benefits of this approach compared with a formal surgical repair either by pars plana vitrectomy (PPV) and/or scleral buckling (SB). We report a retrospective case series of retinal detachments (RD) satisfying the strict selection criteria for PR but who were managed with formal surgery. Single-operation success rate for PPV/SB at six months follow-up was 93.8% in our study, higher than published primary success rates for PR (60-80%). When counselling patients for possible PR, the ease, speed and potentially reduced co-morbidity of an outpatient-based procedure needs to be balanced against its significantly higher failure rate in comparison with primary PPV/SB.

Keywords: Consent; ophthalmology; retinal surgery.

MeSH terms

  • Aged
  • COVID-19 / prevention & control
  • COVID-19 / transmission
  • Female
  • Humans
  • Informed Consent / legislation & jurisprudence
  • Informed Consent / standards*
  • Male
  • Middle Aged
  • Retina / physiopathology
  • Retina / surgery*
  • Retinal Detachment / surgery*
  • Retrospective Studies
  • Scleral Buckling / standards*
  • Scleral Buckling / statistics & numerical data
  • Vitrectomy / standards*
  • Vitrectomy / statistics & numerical data