Retinal Displacement After Pneumatic Retinopexy Versus Vitrectomy for the Management of Primary Retinal Detachment
Conditions: Retinal Detachment, Metamorphopsia, Aniseikonia
Sponsor: Unity Health Toronto

Retinal Displacement after pneumatic retinopexy versus vitrectomy for primary retinal detachment – Protocol, 
version date Aug 06, 2019 
STUDY PROTOCOL (Version 3, Aug 06, 2019)  
Title: Retinal displacement after pneumatic retinopexy versus vitrectomy for 
the management of primary retinal detachment.  
Principal Investigators:  
Dr. Rajeev Muni  
Dr. Carolina Francisconi 
 
Co-investigators:  
Dr. Alan Berger  
Dr. Filiberto Altomare  
Dr. David Wong  
Dr. Louis Giavedoni 
Dr. David Chow 
Study coordinator:  
Philip To 
Backup coordinator:  
  
Setting: Ophthalmology department, St Michael’s Hospital, Toronto:  
1. St Michael’s Hospital Eye Clinic, 8th Floor, 61 Queen St East, Toronto M5C 
2T2  
2. Eye treatment room, 8th Floor, Cardinal Carter wing, St Michael’s Hospital, 
Toronto M5B 1W8  
 

Retinal Displacement after pneumatic retinopexy versus vitrectomy for primary retinal detachment – Protocol, 
version date Aug 06, 2019 
 
I. Background  
Retinal detachment  
Rhegmatogenous retinal detachment (RRD) is an acute, sight threatening 
condition, with an incidence of approximately 10 per 100,000 people.1 During 
normal ageing, the transparent vitreous gel (see figure 1:A), which fills the eye, 
liquefies and shrinks, and eventually detaches in 80% of the eyes. When 
detachment of the gel occurs, a tear in the retina may form (see figure 1:B). 
Liquified gel may now enter under the retina via the retinal tear (see figure 1:C), 
resulting in detachment of the retina (see figure 1:D). Once retinal detachment 
occurs, sight loss usually develops within several hours to days.  
Figure 1: Retinal detachment  
 
Factors that predispose an individual to developing retinal detachment are myopia 
(near sightedness), advancing age, trauma, and certain hereditary conditions.
2  

Retinal Displacement after pneumatic retinopexy versus vitrectomy for primary retinal detachment – Protocol, 
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Without surgical intervention by a vitreoretinal surgeon, retinal detachment almost 
invariably results in permanent sight loss in the affected eye. There is an increased 
risk of delayed visual rehabilitation the longer the wait for surgery is.
3 Both of the 
treatments under investigation are widely used and accepted by vitreoretinal 
surgeons
4  
Interventions for retinal detachment Pneumatic retinopexy (PnR) has been 
employed to repair retinal detachments since the late 1980s and is a minor surgical 
intervention, carried out in a treatment room. The initial success rate (i.e. the 
proportion of patients in whom the retina becomes attached after one treatment) is 
quoted as approximately 70%.5-7. PnR is carried out under topical or local 
anaesthetic (a freezing injection under the conjunctiva, the superficial skin on the 
eye). The procedure involves injection of a small gas bubble into the eyeball via a 
fine needle. This step takes a maximum of 15 minutes. Two gases can be injected 
into the eye: perfluoropropane (C3F8), which lasts 6 weeks, and sulfahexafluoride 
(SF6), which lasts about 2 weeks. Both are non-toxic, equally effective, have been 
validated for this use, and are widely used amongst retina surgeons in the world. 
After injection of the gas bubble, the patient is required to maintain a strict ‘head 
posture’ (for example, head tilt to left) for up to 10 days. The purpose of this ‘head 
posture’ is to align the gas bubble (which floats within the eye) to the retinal tear. 
The buoyant force of the gas bubble, as well as its surface tension, act to reattach 
the detached retina over several days. The gas bubble spontaneously dissipates 
after 2-6 weeks, depending on the gas selected. Additionally, laser treatment or 
cryotherapy is carried out either before or 1-2 days after injection of the gas 
bubble, to secure the retinal tear. Without this second step, the retina would re-
detach once the gas bubble dissipates. Both laser and cryotherapy are widely 

Retinal Displacement after pneumatic retinopexy versus vitrectomy for primary retinal detachment – Protocol, 
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accepted methods of securing the tears in the retina and both are considered 
equally safe and effective. In patients where the retina does not reattach with PnR 
alone, vitrectomy surgery (PPV) or repeat PnR is needed (see below).8 However, 
the minority of patients who go on to need repeat treatment encounter similar final 
anatomical success rates and will experience the same gain in vision as those 
patients who underwent PPV in the first place.9,11  
Vitrectomy surgery (PPV) involves ‘keyhole’ surgery to the eyeball, via three tiny 
(23/25 gauge) incisions to the sclera. This procedure is carried out in the operating 
room, under regional anaesthetic (a freezing injection to the retro-bulbar space, the 
space behind the eyeball, where nerves which sense pain and control eye 
movement are situated) plus sedation (medication to reduce patient anxiety). 
During PPV, the vitreous gel is removed from the eye using a fine metal 
instrument called a ‘vitrector’. The vitreous gel is removed to allow space for a 
larger gas bubble than is possible in PnR, and also to relieve any vitreous traction 
which may otherwise impair reattachment of the retina. A large gas bubble (same 
gases as mentioned for PnR) is injected (to reattach the retina, as in PnR), and laser 
or cryotherapy is applied around the retinal tear to secure it (as in PnR). After 
treatment, a patient may be required to maintain a ‘head posture’ (for example, 
head tilt to left) for up to one week. The purpose of this ‘head posture’ is to support 
the area of the retinal tear optimally, by ‘floating’ the gas bubble up against it. As 
the gas bubble is larger in PPV, the head posturing requirements are less strict. The 
gas bubble reabsorbs after 2-6 weeks, depending on the gas selected. The surgery 
takes 1-1.5 hours. The success rate (i.e. the proportion of patients in whom the 
retina becomes attached after one treatment) is reported as being as high as 90% in 
the scientific literature.7,12,13  

Retinal Displacement after pneumatic retinopexy versus vitrectomy for primary retinal detachment – Protocol, 
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Both of the treatments may be associated with complications such as bleeding, 
infection, increased intraocular pressure or cataract. The risk of a sight threatening 
complication such as a severe intraocular infection or hemorrhage is less than 
1:1000 (for both procedures). The risk of cataract development (clouding of the 
lens, requiring cataract extraction surgery) is less than 10% for PnR11,14 and at 
least 70% for PPV.15  
 
 

Retinal Displacement after pneumatic retinopexy versus vitrectomy for primary retinal detachment – Protocol, 
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Distortion and retinal displacement after retinal detachment repair  
Image distortions such as metamorphopsia and micropsia are common complaints 
after surgery for retinal detachment. In 2010 Shiragami et al were the first to 
demonstrate hyper-fluorescent lines, adjacent to the retinal blood vessels in Fundus 
auto-fluorescence imaging (FAF) of the retina after retinal detachment (RD) repair 
surgery 26. They proposed a theory in which these lines which are called also Retinal 
Vessel Printing (RVP) correspond to the area where the retinal blood vessels were 
located before the retinal detachment. According to this theory the RVP in FAF 
imaging is due to increased metabolic activity of RPE cells. Prior to surgery these 
RPE cells were obscured to light rays by retinal blood vessels while after surgery, 
due to displacement of the retina, these RPE cells became exposed to the light which 
leads to increase in the cells metabolic activity. This increase in metabolism is 
thought to be the cause for the hyper fluorescence seen in FAF imaging. 
Displacement of the retina after RD repair surgery can serve as anatomy basis of 
vision distortion. Moreover, these reference lines allow us to quantify the 
displacement of the retina after retinal detachment surgeries. By doing this, we can 
compare retinal displacement of different retinal detachment repair surgeries and 
may reduce post operation visual distortion.     
Since Shiragami’s first report, several other studies looked into retinal displacement 
after RD repair26-32, epiretinal membrane33 and macular hole34. Codenotti et al have 
shown that retinal displacement ratio is higher in patients with intravitreal gas 
compare to patients with silicon oil (71.4% vs. 22.2%)27. Lee et al proposed a way 
of quantifying the rotational displacement of the retina28. They showed that there is 
more than a simple rotation and probably also a temporal stretch of the retina. 
Dell’omo described additional OCT and FAF changes after RD repair such as outer 
retinal folds and IS/OS skip reflectivity abnormalities29. Recently Dell’omo 

Retinal Displacement after pneumatic retinopexy versus vitrectomy for primary retinal detachment – Protocol, 
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published the biggest study so far of 125 patients after pars plana vitrectomy (PPV) 
with 35.2% of patient showed signs of retinal displacement30. 
Recently we showed in PIVOT trial that patients after pneumatic retinopxy has less 
vertical distortion than patients after PPV. To the best of our knowledge, no study 
so far looked into retinal displacement after Pneumatic Retinopexy. Moreover, 
wide field FAF was not used in previous studies. We think there is a reason to 
believe that Pneumatic Retinopexy will cause less retinal displacement than PPV. 
Thus, we propose a prospective cohort study which will compare retinal 
displacement of patients after RD repair by PPV versus Pneumatic Retinopexy. 
 
 

Retinal Displacement after pneumatic retinopexy versus vitrectomy for primary retinal detachment – Protocol, 
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II. Aim  
To compare retinal displacement and visual distortion of primary retinal 
detachment repair following pneumatic retinopexy (PnR) versus pars plana 
vitrectomy (PPV).  
III. Study design  
(i) Hypothesis The primary study hypothesis is that pneumatic retinopexy will 
cause less retinal displacement and less visual distortion at the first 12 months for 
patients with primary retinal detachment.  
(ii) Experimental design A prospective, cohort trial, comparing two surgical 
interventions (PnR versus PPV) for patients with primary retinal detachment.  
(iii) Participants Patients presenting to St. Michaels Hospital retinal service with 
rhegmatogenous retinal detachment. Eligibility for study participation will be 
ascertained by the examining physician at the time of presentation:  
  
Inclusion criteria:   
• Age ≥ 18 
• Diagnosis of macula off primary rhegmatogenous retinal detachment 
 
 
Exclusion criteria:  
• Previous retinal detachment and/or retinal detachment repair surgery in the 
study eye 
• Retinal detachment with macula on. 
• Patients with other retinal pathologies causing structural changes to the retina 
in the study eye, such as diabetic retinopathy, previous vascular occlusion 
(artery or vein occlusion), macular dystrophy, among others. 
• Previous vitreoretinal surgery in the study eye 
• Inability to come for follow ups up to 12 months. 
• Inability to take FAF imaging due to neck stiffness or other medical issue. 

Retinal Displacement after pneumatic retinopexy versus vitrectomy for primary retinal detachment – Protocol, 
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• Inability to maintain post operation head positioning 
• Mental incapacity 
• Inability to sign on informed consent. 
• Patient is unwilling or unable to follow or comply with all study related 
procedures or to sign informed consent form 
 
Criteria for participant withdrawal from study: - Patient withdraws consent  
(v) Interventions  
Participants will undergo either: PnR + laser/cryotherapy  
or PPV + laser/cryotherapy depending on the treating physician’s 
recommendation, regardless their participation in the study. 
For patients undergoing PPV, the use of adjunctive surgical techniques such as 
placement of a scleral buckle, use of silicone oil, or combined cataract extraction 
are at the discretion of the treating surgeon. All patients undergoing the vitrectomy 
arm, regardless of the additional steps done during the procedure, will be 
considered as one group for data analysis. 
In the event of primary intervention failure (i.e. failure of retinal re-attachment 
following primary intervention), the decision to proceed with secondary 
intervention, and the nature of such intervention, will rest with the treating 
physician in conjunction with the patient. Secondary intervention may involve any 
surgical procedure, as deemed clinically appropriate.  
Note: Additional laser retinopexy, cryotherapy, gas injection or head positioning 
are not considered a failure.  
 (vi) Timing of observations See flow diagram (Appendix 1)  
(vii) Outcome measures  
Primary outcome:  
- retinal displacement by the presence of retinal vessels printing on FAF imaging. 
Secondary outcome: 

Retinal Displacement after pneumatic retinopexy versus vitrectomy for primary retinal detachment – Protocol, 
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- Visual Distortion measured with M chart. 
- Anisokenia testing. 
- Optical Coherence Tomography (OCT) changes. 
- Metamorphopsia according to the patient symptoms.    
- Visual acuity (ETDRS 12 months post intervention) 
- Metamorphopsia questionnaire  
imaging 
Fundus AutoFluorescence (FAF) 
Fundus autofluorescence (FAF) imaging is a noninvasive imaging method and 
requires relatively little time. It highlights the fluorophores accumulating in 
lipofuscin (LF) within retinal pigment epithelium cells (RPE). No radiation is 
involved therefore this imaging method is safe without any clear contraindications. 
M Chart 
Recently, several tools have been developed for quantification of metamorphopsia 
severity including M-CHARTS (Inami Co., Tokyo, Japan). In the patients with 
metamorphopsia, a straight line appeared curved or irregular. On M-CHARTS, 
straight lines are replaced with dotted lines, and the dot intervals (range: 0.2° - 
2.0°) are changed from fine to coarse. With increasing dot interval, the line 
distortion decreases until the dotted line becomes straight. The visual angle that 
denoted the dot interval of the line seen as straight was considered as the patient’s 
M-CHARTS score. When a patient was tested with vertical dotted lines, the result 
was defined as the vertical M-CHARTS score. After the M-CHARTS were rotated 
90°, the horizontal M-CHARTS score also was measured according to horizontal 
dotted lines35. 

Retinal Displacement after pneumatic retinopexy versus vitrectomy for primary retinal detachment – Protocol, 
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Aniseikonia test 
Aniseikonia is a phenomenon in which the size or shape of perceived images 
differs between eyes. The anomaly is reported to be associated with interocular 
differences in refractive error and some retinal diseases. Following successful 
repair for rhegmatogenous retinal detachment, some patients have complained that 
objects appeared distorted in size or shape. The Aniseikonia Test measures the 
ratio of image size difference between the 2 eyes36. 
  
(viii) Recruitment plan 
Recruitment will begin in March 2018 after Research Ethics Board approval has 
been granted and will continue until the required number of patients are enrolled and 
have completed the study.  Patients visiting the St. Michael’s Hospital’s retina clinic 
with primary RRD will be given the option to participate if they meet the 
criteria.  Based on our clinic’s routine volume, we anticipate recruiting 
approximately 4 patients per sub-study per week, with complete recruitment over a 
12-month period. Each patient will be followed for 12 months.  
  
(ix) Screening Procedures 
Patients will be screened by the investigators in the same manner as standard 
patients.  The tests to be performed are typically used for diagnosis and follow-up of 
retinal detachment: best-corrected Snellen visual acuity assessment, slit-lamp exam, 
tonometry, fundoscopy, and Optical Coherence Tomography (OCT) at every visit. 
ETDRS visual acuity (ETDRS - ‘Early treatment of Diabetic Retinopathy Study’ – 
this study defined a method of visual acuity assessment that has become the gold 

Retinal Displacement after pneumatic retinopexy versus vitrectomy for primary retinal detachment – Protocol, 
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standard for use in eye research) will be assessed at 12 months after the treatment 
for RRD. 
Assessment of Clinical Parameters: 
The following clinical data will be obtained from each patient: age, gender, extent 
of the detachment (quadrants), duration of subjective symptoms (days), vitreous 
status (presence/absence of vitreous hemorrhage), macular status (attached/on or 
detached/off), the location of main retinal tears (fundus sketch), refractive power 
(emmetropic, hyperopic, myopic <6 or > 6 diopters, lens status (phakic or 
pseudophakic) and medications in use. 
  
 (x) Sample size 
Sample sizes for each sub-study were calculated for a 5% level of statistical 
significance with 80% power. Assuming displacement ratio of 35% and 15% in the 
vitrectomy and pneumatic groups respectively, A total sample size of 80 subjects 
will be required for each group. Anticipating a dropout rate of 10%, we calculated a 
total of 180 patients in the study. 
 
 IV. Data management  
Initial data collection (clinical examination findings, visual acuity, questionnaire 
data) will take place in a paper format. Subsequently, this data will be transferred 
to a digital database (Microsoft Excel). Paper data will be stored in a locked filing 
cabinet in the principal investigator’s office and away from the study data, and will 
be destroyed once digital data entry has taken place. The digital spreadsheet will be 
held on a password protected computer in a locked room, and an encrypted 
memory stick. At recruitment, each patient’s name and date of birth will be 
obtained to facilitate onward administration of follow-up appointments and safety 

Retinal Displacement after pneumatic retinopexy versus vitrectomy for primary retinal detachment – Protocol, 
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monitoring, and stored on a face sheet (master linking log). The face sheets will be 
stored in a locked filing cabinet, away from the study data. Each patient will be 
allocated a unique study identification number, which will be used to label all 
paper and digital data pertaining to that patient. The face sheets (master linking 
log) and all paper/electronic data will be destroyed once publication takes place. 
The de-identified study data will be destroyed five years after publication has taken 
place.  
V. Consent:  
Written, informed consent will be obtained from each participant. On no occasion 
should consent be obtained by the treating physician or study investigator. During 
working hours: The study will be introduced to the patient by the examining 
physician. Interested patients are directed to Philip To (Research Technician) who 
will obtain informed consent.  
Late evenings / weekends: Our Research Technician (Philip To) will generally be 
available to obtain informed consent from potential study patients outside normal 
working hours, on an ‘on call’ basis. However, on occasions when he is 
unavailable, informed consent may instead be obtained by the Ophthalmology 
resident or fellow (assuming that they are not the treating physician and will not be 
involved in the patient’s surgery). The resident/fellow will be familiar with both 
interventions (PnR and PPV), the nature of the study and trained to the consent 
discussion and obtaining written informed consent. Since retinal detachments are 
usually unilateral conditions, patients can still read the informed consent. If the 
patient has any bilateral visual impairment, the research technician will be 
available to help and read the consent to the participant. In this situation, a witness, 
usually being the accompanying relative of the patient or a SMH staff member not 

Retinal Displacement after pneumatic retinopexy versus vitrectomy for primary retinal detachment – Protocol, 
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involved in the study, will also be present.  
VI. Data Analysis:  
Continuous data: Data will be checked for normality. Normal data will be 
compared using a non-paired t-test.  
Non-normal data will be compared using non parametric tests. Categorical data: 
Chi squared test.  
Coefficients with 95% confidence intervals will be reported. A p-value of 0.05 will 
be considered for statistical significance. Data will be analyzed using SPSS (SPSS 
Inc., Chicago, IL). Per protocol analysis will be used.  
 
 
VII. Safety Monitoring Plan 
 This study will be conducted in accordance to the Declaration of Helsinki. The local 
principal investigator will meet monthly with study team members to review the 
progress of the study. Furthermore, to ensure that all members are performing their 
roles in accordance with the professional obligations described in this Ethics 
Application, the Principal Investigator will randomly check on the study 
coordinators and participants. Patients will be made fully aware of the risks and 
benefits of the procedures. Patients will be assessed before and after the treatment 
and will be closely monitored throughout the study. Complications will be managed 
by highly trained hospital staff including ophthalmologists, nurses, allied health 
professionals and technicians as per standard of care. 
VIII. Funding 
All aspects of clinical care, including procedures visits and exams, carried out as 
part of the study represent standard of care. 
  

Retinal Displacement after pneumatic retinopexy versus vitrectomy for primary retinal detachment – Protocol, 
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Support staff: Our research technician (Philip To) is already a salaried employee 
within the department. Part of his existing job description is assisting Fellow’s 
research, and therefore no additional funds will be required. 
Expenses with printing and copying will be absorbed by the principal investigator’s 
(Dr. Rajeev Muni) office. 
 
 
 
 

Retinal Displacement after pneumatic retinopexy versus vitrectomy for primary retinal detachment – Protocol, 
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M. Macula- on versus macula-off pseudophakic rhegmatogenous retinal 
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4. Saw S, Gazzard G, Wagle AM, Lim J, Au Eong K. An evidence-based 
analysis of surgical interventions for uncomplicated rhegmatogenous retinal 
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5. Kulkarni KM, Roth DB, Prenner JL. Current visual and anatomic outcomes 
of pneumatic retinopexy. Retina (Philadelphia, Pa.). 2007 Oct;27(8):1065–
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6. Tornambe PE. Pneumatic retinopexy: the evolution of case selection and 
surgical technique. A twelve-year study of 302 eyes. Trans Am Ophthalmol 
Soc. 1997;95:551–78. 
7. Schaal S, Sherman MP, Barr CC, Kaplan HJ. PRIMARY RETINAL 
DETACHMENT REPAIR: Comparison of 1-Year Outcomes of Four 
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8. Hilton GF, Grizzard WS. Pneumatic retinopexy. A two-step outpatient 
without conjunctival incision. Ophthalmology. 1986;93(5):626-41. 
9. Goldman DR, Shah CP, Heier JS. Expanded criteria for pneumatic 
retinopexy and potential cost savings. Ophthalmology. 2014;121:318-326. 
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11. Tornambe PE, Hilton GF, Brinton DA, Flood TP, Green S, Grizzard WS, et 
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CJ. Primary vitrectomy without scleral buckling for pseudophakic 
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13. Brazitikos PD, Androudi S, Christen WG, Stangos NT. Primary pars plana 
vitrectomy versus scleral buckle surgery for the treatment of pseudophakic 
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2005 Dec;25(8):957–64. 
14. Mougharbel M, Koch FH, Böker T, Spitznas M. No cataract two years after 
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MH. Scleral Buckling versus Primary Vitrectomy in Rhegmatogenous 
Retinal Detachment: A Prospective Randomized Multicenter Clinical Study. 
Ophthalmology. 2007 Dec;114(12):2142–2154.e4.  
16. Mangione CM, Lee PP, Gutierrez PR, Spritzer K, Berry S, Hays RD. 
Development of the 25-item National Eye Institute Visual Function 
Questionnaire. Arch. Ophthalmol. 2001 Jul;119(7):1050–8. 
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Quality of Life and Visual Function after Vitrectomy for Various 
Vitreoretinal Disorders. Investigative Ophthalmology & Visual Science. 
2010 Feb 1;51(2):744 –751.  
18. Okamoto F, Okamoto Y, Hiraoka T, Oshika T. Vision-related quality of life 
and visual function after retinal detachment surgery. Am J Ophthalmol. 2008 
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21. Ghazi-Nouri SMS. Visual function and quality of life following vitrectomy 
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1;90:559–62. 
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detachments undergoing primary vitrectomy. Ophthalmology. 2007 
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detachment. Acta Ophthalmol Scand. 2007 Aug;85(5):540–5. 
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measurements? Invest. Ophthalmol. Vis. Sci. 2003 Aug;44(8):3278–81.  
26. Unintentional displacement of the retina after standard vitrectomy for 
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Fukuda K, Takagishi M, Morita M, Kishikami T. Ophthalmology. 2010 
Jan;117(1):86-92. 
27. Influence of intraocular tamponade on unintentional retinal displacement 
after vitrectomy for rhegmatogenous retinal detachment. Codenotti M, 
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Benedetto U, Bandello F. Retina. 2013 Feb;33(2):349-55. 
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Laidlaw DA. Br J Ophthalmol. 2013 Oct;97(10):1297-302. 
29. Early simultaneous fundus autofluorescence and optical coherence 
tomography features after pars plana vitrectomy for primary 
rhegmatogenous retinal detachment. Dell'Omo R, Mura M, Lesnik Oberstein 
SY, Bijl H, Tan HS. Retina. 2012 Apr;32(4):719-28 
30. Incidence and relation with anatomical and functional variables of 
postoperative macular displacement in rhegmatogenous retinal detachment. 
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31. Incidence and Factors Influencing Retinal Displacemet in Eyes Treated for 
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32. Metamorphopsia and outer retinal morphologic changes after successful 
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Okuda, Tetsuhiko MD, PhD; Higashide, Tomomi MD, PhD; Sugiyama, 
Kazuhisa MD, PhD. Retina. 2018 Jan;38(1):148-154. 

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33. Measurment of retinal displacement and metamorphopsia after epiretinal 
membrane or macular hole surgery. Rodrigues IA, Lee EJ, Williamson TH. 
Retina. 2016 Apr;36(4):695-702.  
34. Retinal displacement toward optic disc after internal limiting membrane 
peeling for idiopathic macular hole. Ishida M, Ichikawa Y, Higashida R, 
Tsutsumi Y, Ishikawa A, Imamura Y. Am J Ophthalmol. 2014 
May;157(5):971-7. 
35. Clinical parameters related to metamorphopsia outcome in patients with       
resolved central serous chorioretinopathy using M-CHART: 
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Ophthalmol. 2015 Dec 18;15:180.  
36. Aniseikonia Following Pneumatic Retinopexy for Rhegmatogenous Retinal 
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Ophthalmol. 2014 Nov;158(5):1056-61. 
 
 
 

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Appendix 1: STUDY FLOWCHART (ALL PATIENTS)  
     
  
 
 
 
 
 
 
 
 
 
INITIAL 
ASSESSMENT 
 
VA (Snellen) 
DATA: Demographics Baseline 
li i
l
INTRA OP 
DATA- procedure, complications 
 
FUNDUS AUTOFLUORESCENCE 
 
 
ANISOKONIA testing 
OCT 
3 MONTHS 
 
M CHART-METAMORPHOPSIA 
 
M QUESTIONNAIRE 

Retinal Displacement after pneumatic retinopexy versus vitrectomy for primary retinal detachment – Protocol, 
version date Aug 06, 2019 
 
 
 
FUNDUS AUTOFLUORESCENCE 
 
VA (ETDRS) 
 
M CHART-METAMORPHOPSIA 
  
ANISEIKONIA 
12 MONTHS 
OCT 
M QUESTIONNAIRE