[Pneumatic retinopexy--method of choice in treatment of retinal detachment]

Authors are presenting their experience with pneumatic retinopexy (PR) in the therapy of primary rhegmatogenous retinal detachment. Technique was for the first time described by Hilton and Grizzard in 1986 as an intravitreal injection of expending gas in combination with transconjunctival cryotherapy or laser photocoagulation of retinal tears. After gas application a patient, particularly his head, must be positioned the way that the rising gas bubble perfectly seals the retinal tear. This also subretinal fluid to be reabsorbed. In the study group of 30 eyes, 11 were pseudophakic and 19 phakic. The reattachment after single PR operation was 77% (23 eyes), in 24% (7 eyes) of cases reoperation was needed. 2 cases required multiple injection of the gas, in 5 cases retinal reattachment after PR was never occurred. The most common causes of failure to reattach the retina were initiation and acceleration of proliferative vitreoretinopathy. In these cases a following operation was needed--most frequently pars plana vitrectomy with tamponading the vitreous cavity by gas or silicone oil. The final reattachment rate was then 94% (28 eyes), one patient refused reoperation, in one case retina remained detached. Pneumatic retinopexy is quite modest and time-saving operative technique which can be used in indicated cases as a one-day surgical procedure, which corresponds with current heading of the eye microsurgery. Although there is always the possibility of failure to reattach the retina using PR as a method of choice. The risk of failure can be significantly lowered by adequate selection of patients.