PNEUMATIC RETINOPEXY FOR GIANT RETINAL TEARS

Background: New techniques adapted for vitrectomy surgery, including t he use of silicone oil and perfluorocarbon liquids, have been applied very successfully to giant retinal tears. Most surgeons thus turn imme diately to vitrectomy for all giant tears. The authors have found that patients with giant tears usually have such rapid flow of fluid from the vitreous to the aqueous that repeated paracenteses can be performe d without shallowing the anterior chamber, thus allowing injection of sufficient gas into the vitreous cavity to unroll and tamponade the gi ant tear without the need for vitrectomy. This makes pneumatic retinop exy a feasible alternative for those selected fresh giant tears that h ave mobile flaps and extend less than 180 degrees. Methods: Five conse cutive patients with giant retinal tears were treated with pneumatic r etinopexy using paracentesis and two or more gas injections. They were followed at least 2 years. Results: Four of the five tears were succe ssfully reattached, although a new tear developed in one, and scleral buckling surgery was performed 11 months after the pneumatic retinopex y. Conclusion: The authors conclude that pneumatic retinopexy is a rea sonable alternative for selected patients with giant retinal tears.