Pneumatic retinopexy in the treatment of primary rhegmatogenous retinal detachment

Purpose To review the management by pneumatic retinopexy of 31 primary rheg matogenous retinal detachments performed between August 1994 and December 1 997. Methods Ocular indications included superior retinal breaks, no evidence of proliferative vitreoretinopathy (PVR) and ability to posture. Patients wit h inferior breaks and/or areas of vitreoretinal degeneration were excluded. Surgery was performed under local anaesthetic using sulphur hexafluoride ( SF6) or perfluoropropane (C3F8) gas injection. Transconjunctival cryotherap y or laser retinopexy was used to create permanent retinal adhesion. The me an length of patient follow-up was II months (range 5-24 months). Results Thirty-one patients (20 men, 11 women) with a mean age of 63.4 year s (range 29-81 years) underwent pneumatic retinopexy which resulted in init ial retinal reattachment in 22 patients. Two detachments recurred in the fi rst month and a third at 4 months post-operatively, giving an anatomical re attachment rate with one procedure in 19 out of 31 eyes (61%). Of the 12 fa ilures, 7 were reattached with one additional operation and one case reatta ched after multiple procedures, giving an overall reattachment rate of 87%. Post-operatively, new or missed breaks were present in 7 patients (22%) ac id PVR developed in 4 patients (13%). There was no difference in age, gende r or extent of detachment between the failed and reattached groups and pseu dophakia did not appear to be a poor prognostic factor. Conclusion Pneumatic retinopexy can be a useful alternative to conventional rhegmatogenous retinal detachment surgery in carefully selected cases. A l arger study addressing the influence of non-ocular factors is warranted.