Efficiency and safety of pneumatic retinopexy for rhegmatogenous retinal detachment_Chinese Journal of Ocular Fundus Diseases

Authors：

Shi Tingkun , Xia Honghe , Huang Yuqiang , Jin Chuang , Ke Xixuan , Zhang Qi , Liao Xulong ,  Chen Haoyu

Joint Shantou International Eye Center of Shantou University and the Chinese University of Hong Kong, Shantou 515041, China;

Corresponding author：

Chen Haoyu, Email: chy@jsiec.org

Keywords：

Retinal detachment; Retinal perforations; Pneumatic retinopexy; Single operation success rate

DOI：

10.3760/cma.j.cn511434-20220310-00128

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To investigate the efficiency and safety of pneumatic retinopexy for rhegmatogenous retinal detachment (RRD). Methods A prospective case series study. From January 2020 to December 2021, 27 eyes of 27 RRD patients in Joint Shantou International Eye Center were included. Among them, there were 10 males and 17 females; the mean age was 36.0±11.8 years old. There was recurrent retinal detachment in 4 eyes. Best corrected visual acuity (BCVA) and optical coherence tomography were performed. According to whether the retina was successfully reattached after a single intravitreal injection, the patients were divided into a single operation group and a second operation group. All eyes underwent pneumatic retinopexy, the patients received intravitreal injection of 0.3-0.5 ml 100% C₃F₈. On the next day, laser photocoagulation was performed around the retinal breaks. The mean follow-up time was 15.0±6.0 months. Outcome measures included single operation success rate, the BCVA at the last follow up and complications. The age, gender, extent of retinal detachment, number of retinal breaks, and preoperative and postoperative BCVA of patients in the single operation group and the second operation group were compared using Mann-Whiteney test or Fisher's exact test. Results Twenty of the 27 eyes (74.1%, 20/27) had retinal reattachment after single operation, 7 of the 27 eyes (25.9%, 7/27) had retinal reattachment after the second operation. Among the 7 eyes, retinal detachment recurrence after operation, retinal detachment recurrence after tear opening, and retinal detachment recurrence with new tears occurred in 1, 4, and 2 eyes, respectively; retinas were all reattached after scleral buckling or vitrectomy. The BCVA was stable and improved in 14 and 13 eyes, respectively. Compared with the single operation group, the retinal detachment in the second operation group was wider and the BCVA before operation was worse, the differences were statistically significant (Z=－2.842,－2.233; P<0.05). Transient intraocular pressure elevation occurred in 5 eyes; no complications such as infectious endophthalmitis, intraocular hemorrhage and lens damage occurred. Conclusion Pneumatic retinopexy is safe and effective in the treatment of RRD.

Citation： Shi Tingkun, Xia Honghe, Huang Yuqiang, Jin Chuang, Ke Xixuan, Zhang Qi, Liao Xulong, Chen Haoyu. Efficiency and safety of pneumatic retinopexy for rhegmatogenous retinal detachment. Chinese Journal of Ocular Fundus Diseases, 2022, 38(4): 270-274. doi: 10.3760/cma.j.cn511434-20220310-00128 Copy

1.	Hilton G, Grizzard W. Pneumatic retinopexy. A two-step outpatient operation without conjunctival incision[J]. Ophthalmology, 1986, 93(5): 626-641. DOI: 10.1016/s0161-6420(86)33696-0.
2.	Hillier RJ, Felfeli T, Berger AR, et al. The pneumatic retinopexy versus vitrectomy for the management of primary rhegmatogenous retinal detachment outcomes randomized trial (PIVOT)[J]. Ophthalmology, 2019, 126(4): 531-539. DOI: 10.1016/j.ophtha.2018.11.014.
3.	Stewart S, Chan W. Pneumatic retinopexy: patient selection and specific factors[J]. Clin Ophthalmol, 2018, 12: 493-502. DOI: 10.2147/opth.S137607.
4.	王文吉. 孔源性视网膜脱离的手术选择[J]. 中国眼耳鼻喉科杂志, 2003, 3(2): 73-75. DOI: 10.3969/j.issn.1671-2420.2003.02.002.Wang WJ. Selection of operations for rhegmatogenous retinal detachment[J]. Chin J Ophthalmol and Otorhinolaryngol, 2003, 3(2): 73-75. DOI: 10.3969/j.issn.1671-2420.2003.02.002.
5.	Huang CY, Mikowski M, Wu L. Pneumatic retinopexy: an update[J]. Graefe's Arch Clin Exp Ophthalmol, 2022, 260(3): 711-722. DOI: 10.1007/s00417-021-05448-x.
6.	Yannuzzi NA, Li C, Fujino D, et al. Clinical outcomes of rhegmatogenous retinal detachment treated with pneumatic retinopexy[J]. JAMA Ophthalmol, 2021, 139(8): 848-853. DOI: 10.1001/jamaophthalmol.2021.1860.
7.	Sebag J, Tang M. Pneumatic retinopexy using only air[J]. Retina, 1993, 13(1): 8-12. DOI: 10.1097/00006982-199313010-00003.
8.	李恩辉, 张昕, 张芦燕, 等. 改良式充气性视网膜固定手术治疗单纯性孔源性视网膜脱离的临床观察[J]. 中华眼底病杂志, 2021, 37(1): 54-56. DOI: 10.3760/cma.j.cn511434-20200729-00360.Li EH, Zhang X, Zhang LY, et al. Clinical observation of modified pneumatic retinopexy for primary rhegmatogenous retinal detachments[J]. Chin J Ocul Fundus Dis, 2021, 37(1): 54-56. DOI: 10.3760/cma.j.cn511434-20200729-00360.
9.	Sinawat S, Ratanapakorn T, Sanguansak T, et al. Air vs perfluoropropane gas in pneumatic retinopexy: a randomized noninferiority trial[J]. Arch Ophthalmol, 2010, 128(10): 1243-1247. DOI: 10.1001/archophthalmol.2010.230.
10.	Modi YS, Townsend J, Epstein AE, et al. Pneumatic retinopexy for retinal detachment occurring after prior scleral buckle or pars plana vitrectomy[J]. Ophthalmic Surg Lasers Imaging Retina, 2014, 45(5): 409-413. DOI: 10.3928/23258160-20140909-05.
11.	Petrushkin HJ, Elgohary MA, Sullivan PM. Rescue pneumatic retinopexy in patients with failed primary retinal detachment surgery[J]. Retina, 2015, 35(9): 1851-1859. DOI: 10.1097/IAE.0000000000000546.
12.	Rootman DB, Luu S, M Conti S, et al. Predictors of treatment failure for pneumatic retinopexy[J]. Can J Ophthalmol, 2013, 48(6): 549-552. DOI: 10.1016/j.jcjo.2013.05.002.
13.	Hilton GF, Tornambe PE. Pneumatic retinopexy. An analysis of intraoperative and postoperative complications. The Retinal Detachment Study Group[J]. Retina, 1991, 11(3): 285-294. DOI: 10.1097/00006982-199111030-00003.
14.	Baker SR, Hainsworth DP. Suprachoroidal gas as a complication of pneumatic retinopexy[J]. Retina, 2000, 20(2): 224-225. DOI: 10.1097/00006982-200002000-00025.
15.	Goldman DR, Shah CP, Heier JS. Expanded criteria for pneumatic retinopexy and potential cost savings[J]. Ophthalmology, 2014, 121(1): 318-326. DOI: 10.1016/j.ophtha.2013.06.037.

1. Hilton G, Grizzard W. Pneumatic retinopexy. A two-step outpatient operation without conjunctival incision[J]. Ophthalmology, 1986, 93(5): 626-641. DOI: 10.1016/s0161-6420(86)33696-0.
2. Hillier RJ, Felfeli T, Berger AR, et al. The pneumatic retinopexy versus vitrectomy for the management of primary rhegmatogenous retinal detachment outcomes randomized trial (PIVOT)[J]. Ophthalmology, 2019, 126(4): 531-539. DOI: 10.1016/j.ophtha.2018.11.014.
3. Stewart S, Chan W. Pneumatic retinopexy: patient selection and specific factors[J]. Clin Ophthalmol, 2018, 12: 493-502. DOI: 10.2147/opth.S137607.
4. 王文吉. 孔源性视网膜脱离的手术选择[J]. 中国眼耳鼻喉科杂志, 2003, 3(2): 73-75. DOI: 10.3969/j.issn.1671-2420.2003.02.002.Wang WJ. Selection of operations for rhegmatogenous retinal detachment[J]. Chin J Ophthalmol and Otorhinolaryngol, 2003, 3(2): 73-75. DOI: 10.3969/j.issn.1671-2420.2003.02.002.
5. Huang CY, Mikowski M, Wu L. Pneumatic retinopexy: an update[J]. Graefe's Arch Clin Exp Ophthalmol, 2022, 260(3): 711-722. DOI: 10.1007/s00417-021-05448-x.
6. Yannuzzi NA, Li C, Fujino D, et al. Clinical outcomes of rhegmatogenous retinal detachment treated with pneumatic retinopexy[J]. JAMA Ophthalmol, 2021, 139(8): 848-853. DOI: 10.1001/jamaophthalmol.2021.1860.
7. Sebag J, Tang M. Pneumatic retinopexy using only air[J]. Retina, 1993, 13(1): 8-12. DOI: 10.1097/00006982-199313010-00003.
8. 李恩辉, 张昕, 张芦燕, 等. 改良式充气性视网膜固定手术治疗单纯性孔源性视网膜脱离的临床观察[J]. 中华眼底病杂志, 2021, 37(1): 54-56. DOI: 10.3760/cma.j.cn511434-20200729-00360.Li EH, Zhang X, Zhang LY, et al. Clinical observation of modified pneumatic retinopexy for primary rhegmatogenous retinal detachments[J]. Chin J Ocul Fundus Dis, 2021, 37(1): 54-56. DOI: 10.3760/cma.j.cn511434-20200729-00360.
9. Sinawat S, Ratanapakorn T, Sanguansak T, et al. Air vs perfluoropropane gas in pneumatic retinopexy: a randomized noninferiority trial[J]. Arch Ophthalmol, 2010, 128(10): 1243-1247. DOI: 10.1001/archophthalmol.2010.230.
10. Modi YS, Townsend J, Epstein AE, et al. Pneumatic retinopexy for retinal detachment occurring after prior scleral buckle or pars plana vitrectomy[J]. Ophthalmic Surg Lasers Imaging Retina, 2014, 45(5): 409-413. DOI: 10.3928/23258160-20140909-05.
11. Petrushkin HJ, Elgohary MA, Sullivan PM. Rescue pneumatic retinopexy in patients with failed primary retinal detachment surgery[J]. Retina, 2015, 35(9): 1851-1859. DOI: 10.1097/IAE.0000000000000546.
12. Rootman DB, Luu S, M Conti S, et al. Predictors of treatment failure for pneumatic retinopexy[J]. Can J Ophthalmol, 2013, 48(6): 549-552. DOI: 10.1016/j.jcjo.2013.05.002.
13. Hilton GF, Tornambe PE. Pneumatic retinopexy. An analysis of intraoperative and postoperative complications. The Retinal Detachment Study Group[J]. Retina, 1991, 11(3): 285-294. DOI: 10.1097/00006982-199111030-00003.
14. Baker SR, Hainsworth DP. Suprachoroidal gas as a complication of pneumatic retinopexy[J]. Retina, 2000, 20(2): 224-225. DOI: 10.1097/00006982-200002000-00025.
15. Goldman DR, Shah CP, Heier JS. Expanded criteria for pneumatic retinopexy and potential cost savings[J]. Ophthalmology, 2014, 121(1): 318-326. DOI: 10.1016/j.ophtha.2013.06.037.

Chinese Journal of Ocular Fundus Diseases

Efficiency and safety of pneumatic retinopexy for rhegmatogenous retinal detachment

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content