Results and prognostic factors in pneumatic retinopexy

We analyzed 133 consecutive cases of primary retinal detachment treated by pneumatic retinopexy (PR). The postoperative follow-up period was at least 6 months (mean, 16.7 months; maximum, 36 months). In all, 97 cases (72.9%) were successfully treated by a single PR. In 19 cases (14.3%) primary reattachment was not achieved. In another 17 cases (12.8%) redetachment occurred. Redetachment was never observed later than 6 months following PR. It was caused by missed or new retinal tears in 8 eyes (6.0%) and by proliferative vitreoretinopathy in 7 eyes (5.3%). A final reattachment rate of 98.5% was achieved. Preoperative factors suggesting primary failure or redetachment were (1) extensive retinal detachment (P < 0.01), (2) pseudo- or aphakia (P = 0.01), (3) the retinal status of the fellow eye (P < 0.05), and (4) poor visual acuity in cases of attached macula (P < 0.01). In cases with preoperatively detached macula, visual acuity (VA) recovered considerably better following PR than following conventional buckling procedures. As compared with cases of successful PR, recovery of VA in all eyes requiring reoperation was significantly reduced. It was, however, still equivalent to the VA of eyes treated by scleral buckling. Surgical success is influenced by preoperative factors such as pseudo- or aphakia, extensive retinal detachment, poor initial VA in cases of attached macula, or the state of the fellow eye. These factors have to be taken into consideration in decisions for or against PR. The anatomical and functional outcome proves the value of this technique in the treatment of primary rhegmatogenous retinal detachment.