Pneumatic retinopexy for primary repair of rhegmatogenous retinal detachments

Abstract

Purpose: To evaluate anatomical and functional outcomes of pneumatic retinopexy (PR) for primary repair of rhegmatogenous retinal detachments and to determine demographic and ocular risk factors for failure of the procedure.

Design: Retrospective interventional case series.

Methods: A chart review on 97 eyes of 97 consecutive patients who had undergone PR as the initial procedure for unilateral recent primary retinal detachments with causative break(s) in the superior two-third of the retina. After injection of 0.35 mL to 0.60 mL of sulfur hexafluoride, 6 hours face-down positioning, and the steamroller maneuver, the patient's head position was changed so that the gas could efficiently tamponade the retinal break(s). Pre- and post-gas injection laser photocoagulation of break(s) and 360° peripheral retina was applied.

Results: Seventy-two male and 25 female patients were included in this study. The single-operation success rate was 82.5%. The pars plana vitrectomy procedure as the second intervention was not adversely affected by the preceding PR. Presence of proliferative vitreoretinopathy (odds ratio: 58.7, 95% confidence interval: 7.8-443.5) and delay between initial symptoms and PR (odds ratio: 1.21 per each additional day, 95% confidence interval: 1.07-1.37) were the only independent predictors for the failure.

Conclusion: With proper selection of cases, PR is a good surgical option for primary rhegmatogenous retinal detachments with acceptable success rate, minimal discomfort to the patient, and minimal surgical risks.