Air as tamponade for retinal detachments

To determine whether air can be used as a reliable tamponade agent after pars plana vitrectomy in selected primary retinal detachment (RD).

Twelve eyes with fresh RD were included. Exclusion criteria were presence of fibrosis, fixed folds, proliferative vitreoretinopathy of grade C or greater, and giant retinal tears. The number, location, and types of breaks, extension of RD, and whether the macula was attached were documented. A 25-gauge 3-port pars plana vitrectomy was carried out. Central and peripheral vitreous was removed to eliminate traction and relieve tractional forces provoked by the air bubble injected at the end. Argon endolaser or cryotherapy was applied around all breaks. Filtered air was used as an internal tamponade. Patients were followed up at 24 hours, 1 week, and 1, 3, 6, and 12 months.

Air bubble took 10.7 days (range 7-15 days) to resolve. Visual acuity (VA) improved from 1.35 ± 1.21 logMAR preoperatively to 0.20 ± 0.25 after a follow-up time of 12 months. We achieved a primary postoperative success rate of 100% at 1 month and 91.6% at 12 months.

We achieved a good success rate with air tamponade and limited laser. This approach allows for quicker VA recovery associated with a rapid disappearance of air. This may benefit patients who live at higher altitudes.