Summary:
Authors are presenting their experience with pneumatic retinopexy (PR) in the
therapy of primary rhegmatogenous retinal detachment. Technique was for the
fist time described by Hilton and Grizzard in 1986 as an intravitreal injection of
expending gas in combination with transconjunctival cryotherapy or laser photocoagulation
of retinal tears. After gas application a patient, particularly his
head, must be positioned the way that the rising gas bubble perfectly seals the
retinal tear. This also subretinal fluid to be reabsorbed. In the study group of 30
eyes, 11 were pseudophakic and 19 phakic. The reattachment after single PR
operation was 77 % (23 eyes), in 24 % (7 eyes) of cases reoperation was needed. 2
cases required multiple injection of the gas, in 5 cases retinal reattachment after
PR was never occurred. The most common causes of failure to reattach the retina
were initiation and acceleration of proliferative vitreoretinopathy. In these cases
a following operation was needed – most frequently pars plana vitrectomy with
tamponading the vitreous cavity by gas or silicone oil. The final reattachment rate
was then 94 % (28 eyes), one patient refused reoperation, in one case retina
remained detached. Pneumatic retinopexy is quite modest and time-saving operative
technique which can be used in indicated cases as a one-day surgical
procedure, 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 adequate
selection of patients.
Key words:
pneumatic retinopexy, retinal detachment
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