Pneumatic Retinopexy in the Therapy of Retinal Detachment

Overview

Authors are presenting their experience with pneumatic retinopexy (PR) in thetherapy of primary rhegmatogenous retinal detachment. Technique was for thefist time described by Hilton and Grizzard in 1986 as an intravitreal injection ofexpending gas in combination with transconjunctival cryotherapy or laser photocoagulationof retinal tears. After gas application a patient, particularly hishead, must be positioned the way that the rising gas bubble perfectly seals theretinal tear. This also subretinal fluid to be reabsorbed. In the study group of 30eyes, 11 were pseudophakic and 19 phakic. The reattachment after single PRoperation was 77 % (23 eyes), in 24 % (7 eyes) of cases reoperation was needed. 2cases required multiple injection of the gas, in 5 cases retinal reattachment afterPR was never occurred. The most common causes of failure to reattach the retinawere initiation and acceleration of proliferative vitreoretinopathy. In these casesa following operation was needed – most frequently pars plana vitrectomy withtamponading the vitreous cavity by gas or silicone oil. The final reattachment ratewas then 94 % (28 eyes), one patient refused reoperation, in one case retinaremained detached. Pneumatic retinopexy is quite modest and time-saving operativetechnique which can be used in indicated cases as a one-day surgicalprocedure, which corresponds with current heading of the eye microsurgery.Although there is always the possibility of failure to reattach the retina using PR as amethod of choice. The risk of failure can be significantly lowered by adequateselection of patients.

Key words:
pneumatic retinopexy, retinal detachment