Abstract
Purpose: :
To evaluate the effectiveness of a two-step pneumatic retinopexy (PR) procedure for repair of rhegmatogenous retinal detachment (RRD) as performed by one retinal specialist.
Methods: :
This is a retrospective study of patients who have undergone two-step PR, defined as intravitreal gas injection at patient presentation followed by next-day laser treatment, at Henry Ford Hospital. Laser retinopexy was chosen over cryo-retinopexy to avoid potential proliferative vitreoretinopathy. All patients with RRD selected for PR procedure from November, 2009 to August, 2011 were included. Data collected included age, symptom onset time to presentation, presenting and final visual acuity, lens status, location of tear, macula on or off, type of gas used, follow up time and any additional surgery performed.
Results: :
We evaluated 10 eyes from 10 patients undergoing the two-step PR. The mean age of patients was 63.6 years. On average, patients presented 8.1 days after symptom onset. Seven eyes were phakic and 3 pseudophakic. All 10 eyes had retinal tears within the superior 6 clock hours, and their media were clear. All patients had retinal detachments: 7 eyes (70%) with attached maculae and 3 eyes (30%) with detached maculae. SF6 gas was used in 9 eyes, and C3F8 in 1 eye. Four eyes had subsequent vitrectomy; 2 eyes for failed PR, 1 eye for macular pucker, 1 eye for additional tears found after PR. At presentation, mean visual acuity was 20/20 for macula-on detachments and 20/800 for macula-off detachments. At final follow up at 284 days after presentation, mean visual acuity was 20/20 for macula-on detachments and 20/300 for macula-off detachments (2 patients 20/30, 1 patient HM).
Conclusions: :
The two-step pneumatic retinopexy is a convenient in-office procedure for repair of retinal detachment. In this review, 8 of 10 (80%) patients had successful re-attachment with PR. On average, patients with macula-on detachments maintained their presenting visual acuity while patients with macula-off detachments had significant improvement in visual acuity. This study shows that two-step pneumatic retinopexy can be used effectively in patients with superior tears. Cryo-retinopexy is not absolutely needed for pneumatic retinopexy when the medium is clear.
Keywords: retinal detachment