Pneumatic retinopexy: an update

Huang, Chyong-Yng; Mikowski, Mia; Wu, Lihteh

doi:10.1007/s00417-021-05448-x

Cited by 13 publications

(14 citation statements)

References 78 publications

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“…PR is considered the most minimally invasive treatment for repairing simple RRD. This office-based surgery has been well accepted by retinal surgeons as an alternative option for simple RRD with superior retinal breaks [ 2 ]. A recent multicenter, randomized, controlled clinical trial was performed to compare the outcomes of PR to PPV for primary RRD, the results of which suggested that PR should be considered the first-line treatment for primary RRD meeting the study criteria [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Pneumatic Retinopexy Involving the Use of Intravitreal Air Injection and Laser Photocoagulation for Rhegmatogenous Retinal Detachment in Phakic Eyes

Zhu

Xiang

Huang

et al. 2023

JPM

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The clinical efficacy of pneumatic retinopexy (PR) using intravitreal pure air injection and laser photocoagulation for rhegmatogenous retinal detachment (RRD) remains unknown. Thirty-nine consecutive patients with RRD (39 eyes) were included in this prospective case series. All patients underwent two-step PR surgery containing pure air intravitreal injection and laser photocoagulation retinopexy during hospitalization. The main outcomes were best-corrected visual acuity (BCVA) and primary anatomic success rates after PR treatment. The mean follow-up was 18.3 ± 9.7 months, ranging from 6 to 37 months. The primary anatomic success rate was 89.7% (35/39) after PR treatment. Final reattachment of the retina was achieved in 100% of cases. Macular epiretinal membrane was developed in two patients (5.7%) among successful PR cases during the follow-up. The mean logMAR BCVA value was significantly improved from 0.94 ± 0.69 before surgery to 0.39 ± 0.41 after surgery. The average central retinal thickness was significantly thinner in the RRD eyes of macula-off patients (206.8 ± 56.13 μm) when compared with the fellow eyes (234.6 ± 48.4 μm) at the last follow-up (p = 0.005). This study concluded that an inpatient PR procedure with pure air injection and laser photocoagulation is a safe and effective approach to treating patients with RRD, who may achieve a high single-operation success rate and good visual acuity recovery.

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Section: Introductionmentioning

confidence: 99%

Pneumatic Retinopexy Involving the Use of Intravitreal Air Injection and Laser Photocoagulation for Rhegmatogenous Retinal Detachment in Phakic Eyes

Zhu

Xiang

Huang

et al. 2023

JPM

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“…We have recently reviewed the advantages, disadvantages and outcomes of PR. 7 In the 1970s, Machemer et al, 8 based on the previous work on open sky vitrectomy by Kasner et al, 9 developed PPV. Historically, the main indication of vitrectomy was the removal of vitreous opacities.…”

Section: Introductionmentioning

confidence: 99%

Scleral Buckling: A Look at the Past, Present and Future in View of Recent Findings on the Importance of Photoreceptor Re-Alignment Following Retinal Re-Attachment

Pimentel¹,

Shih²,

Wu³

2022

OPTH

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Scleral buckling (SB) remains an important technique to master for those interested in treating rhegmatogenous retinal detachment (RRD). Several ways to repair RRD include pneumatic retinopexy (PR), pars plana vitrectomy (PPV), SB or a combination of these. There is a growing worldwide trend that favors PPV as the preferred method for retinal reattachment of primary uncomplicated RRD. Reimbursement issues, operating room access, and technological advances in PPV that improve retinal visualization and less exposure to SB during fellowship training may explain this trend. As the number of SB cases decreases over time, there is a risk that SB becomes a dying art and surgeons in training may not be trained in SB. SB is preferred in eyes with no posterior vitreous detachment and retinal dialysis. SB with minimal gas vitrectomy may be indicated for eyes with inferior pathology. Non-contact wide-angled visualization with chandelier assisted SB may be well suited for teaching new generations of aspiring vitreoretinal surgeons. Its functional and anatomic results compare favorably with conventional SB for primary uncomplicated primary RRD. The main advantage of this technique is the improved visualization even through small pupils. Better visualization ensures treatment of all breaks while avoiding complications during drainage of subretinal fluid and a safer placement of intrascleral sutures for scleral fixation of the buckling element. Recordings of the procedure are easily performed, allowing the surgeons involved to review the case and learn from it. The main disadvantage is the cost involved with the chandelier and the need to have a microscope or a 3D system with a wide angle viewing system. Photoreceptor re-alignment following retinal re-attachment is an important determinant of the post-operative functional outcomes. Different methods of retinal re-attachment apparently result in different degrees of photoreceptor re-alignment. SB may hold an advantage over PPV in this regard.

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“…1 PR is considered the most minimally invasive treatment for repairing simple RRD. 2 This o ce-based surgery has been well accepted by retinal surgeons as an alternative option for simple RRD with superior retinal breaks. [2] A recent multicenter, randomized, controlled clinical trial was performed to compare the outcomes of PR to PPV for primary RRD, the results of which suggested that PR should be considered the rst-line treatment for primary RRD meeting the study criteria.…”

Section: Introductionmentioning

confidence: 99%

“…2 This o ce-based surgery has been well accepted by retinal surgeons as an alternative option for simple RRD with superior retinal breaks. [2] A recent multicenter, randomized, controlled clinical trial was performed to compare the outcomes of PR to PPV for primary RRD, the results of which suggested that PR should be considered the rst-line treatment for primary RRD meeting the study criteria. 3 The successful anatomical retinal reattachment rate of single RP treatment ranged from 50-90% in previous studies.…”

Section: Introductionmentioning

confidence: 99%

“…[3][4][5][6][7][8][9] The PR procedure can be performed in one step, with the application of scleral cryopexy to retinal breaks just before intravitreal gas injection, or in a two-step manner, with initial intravitreal gas injection to atten the detached retina, followed by either laser photocoagulation or scleral cryopexy to seal the retinal break. [2] Both procedures have been applied in previous studies, depending on the surgeon's discretion. [3,5] Thus, the e cacy of PR for simple RRD may be compounded due to the different procedures used in a study.…”

Section: Introductionmentioning

confidence: 99%

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Inpatient pneumatic retinopexy involving the use of air injection and laser photocoagulation for uncomplicated rhegmatogenous retinal detachment

Zhu

Xiang

Huang

et al. 2022

Preprint

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Background: To evaluate the clinical efficacy of inpatient pneumatic retinopexy (PR) using pure air intravitreal injection and laser photocoagulation for uncomplicated rhegmatogenous retinal detachment (RRD).Methods: Thirty-nine consecutive patients with uncomplicated RRD (39 eyes) were included in this prospective case series study. All patient underwent two-step PR surgery containing pure air intravitreal injection and laser photocoagulation retinopexy during hospitalization. The main outcomes were best-corrected visual acuity (BCVA) and primary anatomic success rates after PR treatment.Results: The mean follow-up was 18.3 ± 9.7 months, ranging from 6 to 37 months. The primary anatomic success rate was 89.7% (35/39) after PR treatment. The final reattachment of the retina was achieved in 100% of cases. Macular epiretinal membrane was developed in two patients (5.7%) among PR successful cases during the follow-up. The mean logMAR BCVA values was significantly improved from 0.94 ± 0.69 before surgery to 0.39 ± 0.41 after surgery. The average central retinal thickness significantly thinner in the RRD eyes of macular-off patients (206.8 ± 56.13 μm) when compared with the fellow eyes (234.6 ± 48.4 μm) at the last follow-up (P = 0.005).Conclusion: Inpatient PR procedure with pure air injection and laser photocoagulation is a safe and effective approach to treat patients with uncomplicated RRD, who may achieve a high single-operation success rate and good visual acuity recovery.

show abstract

Pneumatic retinopexy: an update

Cited by 13 publications

References 78 publications

Pneumatic Retinopexy Involving the Use of Intravitreal Air Injection and Laser Photocoagulation for Rhegmatogenous Retinal Detachment in Phakic Eyes

Pneumatic Retinopexy Involving the Use of Intravitreal Air Injection and Laser Photocoagulation for Rhegmatogenous Retinal Detachment in Phakic Eyes

Scleral Buckling: A Look at the Past, Present and Future in View of Recent Findings on the Importance of Photoreceptor Re-Alignment Following Retinal Re-Attachment

Inpatient pneumatic retinopexy involving the use of air injection and laser photocoagulation for uncomplicated rhegmatogenous retinal detachment

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