Efficacy of Pneumatic Retinopexy in the Treatment of Primary Rhegmatogenous Retinal Detachment

  Objective  To analyze the efficacy and prognosis of pneumatic retinopexy for primary rhegmatogenous retinal detachment.

  Methods  Totally 16 patients (16 eyes) diagnosed as primary rhegmatogenous retinal detachment and received pneumatic retinopexy in our hospital from August 2008 to July 2012 were enrolled in this study. All the patients received the procedure under topical anesthesia, positioned properly after operation, and underwent retinal photocoagulation 1 to 3 days after the operation. The retinal reattachment rate, visual acuity, and complications of the operation were summarized.

  Results  There were 8 males and 8 females aging 19 to 68 years old (mean 46.4±14.4 years). Their disease course ranged from 3 to 60 days (mean 16.8±14.7 days), and the follow-up time was 1 to 28 months (mean 7.3±7.0 months). Retinal breaks were within the upper 8 clock-hour in 15 cases, and located at the subtemporal retina in 1 case. Fourteen cases had round or horseshoe shaped holes, with 1 hole in 10 cases, 2 holes in 3 cases, and 3 holes in 1 case. The other 2 cases had multiple cribriform holes, but limited in 3 clock-hour extent. Postoperative intraocular pressure rose in 2 cases, and returned to normal after using topical ocular hypotensive medications. Pneumatic retinopexy resulted in reattachment in 13 cases, but redetachment happened in 5 eyes after 4 days to 4 months, including 3 cases of unclosed holes and 2 cases of new retinal holes. Reoperations were carried out for 8 patients, and the final retinal reattachment rate was 100%. Among the 8 cases that succeeded after primary pneumatic retinopexy, visual acuity was improved in 5 cases and stable in 3 cases, with 5 cases attaining visual acuity of 0.5 or more. Among the 8 cases that received two or more operations, visual acuity was improved in 5 cases, stable in 1 case, and decreased in 2 cases, with 3 cases attaining visual acuity of 0.5 or more. Visual acuity improved in 77.8%(7/9) of macular-off cases and 42.9%(3/7) of macular-on cases.

  Conclusions  Pneumatic retinopexy is a simple procedure for primary rhegmatogenous retinal detachment. It can achieve satisfied results in properly selected cases. However, the incidences of new retinal holes and redetachments can be high, so strict indications and close follow-up are particularly important for this procedure.