Pneumatic retinopexy. A two-step outpatient operation without conjunctival incision

Abstract

1,000 consecutive patients operated for retinal detachment were studied prospectively to determine the incidence of complications. Two parts of the operation were responsible for most of the vision-threatening complications: subretinal fluid drainage and the scleral buckle. In an attempt to reduce the complications of retinal detachment surgery, we have utilized a simplified procedure of transconjunctival cryotherapy and intravitreal gas injection with postoperative positioning. This study was limited to detachments with one or more breaks within one clock hour located within the superior eight clock hours of the fundus without signs of proliferative vitreoretinopathy. In a series of 20 consecutive patients, retinal reattachment was initially achieved in all cases. There were two recurrences that were reattached with scleral buckling. The final cure rate for the single pneumatic procedure, with six months follow-up, was 90%. No major complications were observed. This preliminary report suggests that pneumatic retinopexy has the advantages of reduced tissue trauma, no hospitalization, minimal complications, and reduced expense. The major disadvantage is the need for postoperative positioning for five days.