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The Side-Steamroll: a Modified Steamroller Maneuver to Control Fluid Displacement After Pneumatic Retinopexy
Jeffrey M Mah1, Shiva Sabour2,1, Sueellen Demian2,1
1Department of Ophthalmology, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada.
Purpose:
To demonstrate how the side-steamroll, a modified steamroller maneuver, can be used to prevent inferior displacement of subretinal fluid (SRF) after pneumatic retinopexy (PnR) when inferior attached retinal breaks are present.
Methods:
Consecutive case series of four patients with primary rhegmatogenous retinal detachment (RRD) with inferior attached retinal breaks who underwent PnR followed by the side-steamroll. Outcomes included primary reattachment, additional surgical interventions, final reattachment, and final best-corrected visual acuity (BCVA) with a minimum follow-up of 5 months.
Results:
Three of the four eyes achieved primary reattachment. One patient required a rescue combined scleral buckle and pars plana vitrectomy procedure to achieve reattachment. One patient developed a late redetachment from a new break at 3 months requiring a scleral buckle procedure. At the final follow-up, BCVA was improved in three of the four eyes and reattachment was achieved in all eyes.
Conclusions:
The side-steamroll is a promising technique to increase the rate of primary reattachment when performing PnR for RRDs with SRF close to attached retinal breaks below the 08:00 and 04:00 o'clock meridians. Further studies with larger sample sizes are required to further explore this relationship.
