Management of persistent loculated subretinal fluid after pneumatic retinopexy

Aim-To report on the incidence and management of a unique and troublesome c omplication of pneumatic retinopexy-localised, delayed subretinal fluid abs orption (DSRFA). Methods-A retrospective chart review was done for all patients who underwen t pneumatic retinopexy for retinal detachment over a 5 year period to ident ify the patients with DSRFA. Results-Seven phakic patients (five females, two males, age range 26-87 yea rs) were identified with the phenomenon of delayed resolution of subretinal fluid after pneumatic retinopexy and cryotherapy. In four patients the sub retinal fluid involved the macula. Time taken to complete absorption of the subretinal fluid ranged from 10 to 26 months. In one patient there was sti ll residual fluid inferiorly at 18 months of follow up. During the follow u p period additional procedures were performed-scleral buckling (five eyes), pars plana vitrectomy (one eye), and mild laser scatter to extramacular ar eas of shallow subretinal fluid (four eyes). None of these procedures appea red to influence the rate of fluid absorption. Conclusions-Loculated subretinal fluid following pneumatic retinopexy may p ersist for very long periods, extending up to more than 2 years. Additional surgical procedures or laser photocoagulation do not affect the rate of su bretinal fluid absorption. Spontaneous reattachment eventually occurs in mo st eyes, and conservative management is indicated.