The place of Pneumoretinopexy in the Treatment of Primary Detachment of the Retina in a Multidisciplinary Hospital

Objective. To analyze our own long-term results of pneumatic retinopexy in the treatment of rhegmatogenous retinal detachment.

Patients and methods. The treatment outcomes of 244 patients were analyzed. Pneumoretinopexy followed by delimiting retinal laser coagulation was used in 187 patients: in 57 cases, stage C1-D3 PVR events were detected, which required other types of intervention. All patients underwent a complete baseline examination. Hexafluoroethane C2 F6 “Arceole” gas from ARCADOPHTA (France) was usually used as an air-gas tamponade. Delimiting retinal laser coagulation was performed on a Nidek MC-500 Multicolor Laser photocoagulator.

Results. The retina adhered in 183 eyes (97.86 %). In 4 cases, surgery was performed for inferior retinal breaks, including those with a large tear area and extensive detachments: complete retinal reattachment was achieved in 3 cases. Recurrent retinal detachment occurred in 5 patients (2.67 %); repeat pneumatic retinopexy was performed with a positive effect in 1 case; vitrectomy was required in 4 cases due to PVR progression.

Conclusion. The obtained results demonstrate the high efficacy and safety of pneumatic retinopexy followed by delimiting retinal laser photocoagulation in the treatment of patients with rhegmatogenous retinal detachment. The use of this technique, with its high anatomical and functional effect, makes pneumatic retinopexy the procedure of choice in the absence of advanced PVR.

1. Charles S, Calzada J, Wood B. Vitreous Microsurgery. Moscow: MEDpress-inform: 2012:400 (In Russ.). ISBN 978-5-98322-820-7.

2. Murakami K, Jalkh AE, Avila MP, Trempe C L, Schepens C L. Vitreous floaters. Ophthalmology. 1983 Nov;90(11):1271–1276. doi: 10.1016/s0161-6420(83)34392-x.

3. Ophthalmology: national guidelines. Eds by S.E. Avetisov, E.A. Egorov, L.K. Moshetova, V.V. Neroev, H.P. Takhchidi. 3rd ed. revised and enlarged. Moscow: GEOTAR-Media, 2024:952 (In Russ.). doi: 10.33029/9704-8572-9OFT-2024-1-952.

4. Kreissig I. Primary retinal detachment: A review of the development of techniques for repair in the past 80 years. Taiwan J. of ophthalmology. 2016;6(4):161–169. doi: 10.1016/j.tjo.2016.04.006.

5. Mashchenko NV, Khudyakov AYu, Sorokin EL. Comparative analysis of the long-term results of surgical treatment of primary retina detachment using extraand intraocular approaches. Ophthalmоsurgery. 2017;2:17–22 (In Russ.). doi: 10.25276/02354160-2017-2-17-22.

6. Нероев ВВ, Сарыгина OИ. Отслойка сетчатки. М.: ГЭOТАР-Медиа, 2008:343. Neroev VV, Sarygina OI. Retinak detachment. Moscow: GEOTAR-Media, 2008:343 (In Russ.).

7. Shpak AA, Shkvorchenko DO, Gorshkov IM, Yukhananov AV. Comparative analysis of surgical treatment of regmatogenic retinal detachment with lower localization of ruptures with tamponade of the natural cavity or silicone. Ophthalmosurgery. 2023;1:31–36 (In Russ.). doi: https://doi.org/10.25276/0235-41602023-1-31-36.

8. Doga AV, Shkvorchenko DO, Wing LA, Tavere MR, Buryakov DA. Regmatogenic retinal detachment: modern approaches to treatment. Clinical ophthalmology. 2020;20(2):72–78 (In Russ.). doi: 10.32364/2311-7729-2020-20-2-72-78.

9. . Schepens CL. Progress in detachment surgery. Trans. Am. Acad. Ophthalmol. Otolaryngol. 1951;55:607–615.

10. Machemer R, Buettner H, Norton EW, Parel JM. Vitrectomy: a pars plana approach. Trans. Am. Acad.Ophthalmol. Otolaryngol. 1971;75(4):813–820.

11. Shkvorchenko DO, Zakharov VD, Kakunina SA, Belousova EV, Rusanovskaya AV, Norman KS. Comparative estimation of surgical treatment results of rhegmatogenous retinal detachment. Fyodorov Journal of Ophthalmic Surgery. 2015;4:43–50 (In Russ.).

12. Liao L, Zhu XH. Advances in the treatment of rhegmatogenous retinal detachment. Int J Ophthalmol. 2019;12(4):660–667. doi: 10.18240/ijo.2019.04.22.

13. Schöneberger V, Li JQ, Menghesha L, Holz FG, Schaub F, Krohne TU. Outcomes of shortversus long-acting gas tamponades in vitrectomy for rhegmatogenous retinal detachment. Int J Retina Vitreous. 2024 Feb 5;10(1):16. doi: 10.1186/s40942024-00530-y.

14. Zakharov VD, Shpak AA, Shkvorchenko DO, Gorshkov IM, Yukhananov AV. Method of surgical treatment of retinal detachment with lower ruptures with silicone and gas-air tamponade. Patent RU 2737939, 07.12.2020 (In Russ.).

15. Jacobs P. Estimating intraocular gas volume. Ophthalmology. 1988 Oct;95(10):1481. doi: 10.1016/s0161-6420(88)32992-1.

16. Hilton GF, Grizzard WS. Pneumatic retinopexy: a two step outpatient operation without conjuctival incision. Ophthmology 1986;93:626.

17. Janco L, Vida R, Bartos M, Villémová K, Izák M. Plyny vo vitreoretinálnej chirurgii [Gases in vitreoretinal surgery]. Cesk Slov Oftalmol. 2012 Feb;68(1):3–8, 10. Slovak.

18. The classification of retinal detachment with proliferative vitreoretinopathy. Ophthalmology. 1983 Feb;90(2):121–125. doi: 10.1016/s0161-6420(83)34588-7.