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SEQUENTIAL PNEUMATIC RETINOPEXIES FOR THE TREATMENT OF PRIMARY INFERIOR RHEGMATOGENOUS RETINAL DETACHMENTS WITH INFERIOR BREAKS

The Double-Bubble Approach

Alali, Alaa, MB, BCh, BAO, FRCSC*; Bourgault, Serge, MD, FRCSC; Hillier, Roxane J., BSc (MedSci), MBChB, FRCOphth, MSc (ClinEd); Muni, Rajeev H., MD, MSc (Clin Epi), FRCSC*,§; Kertes, Peter J., MD, CM, FRCSC*,¶

doi: 10.1097/IAE.0000000000002369
Original Study: PDF Only

Purpose: To evaluate a new approach of sequential pneumatic retinopexies for the management of inferior rhegmatogenous retinal detachments (RD) with inferior breaks.

Methods: Multicenter retrospective consecutive case series of inferior RDs caused by retinal breaks located within the inferior 4 clock hours treated with sequential pneumatic retinopexies, 24 to 48 hours apart. A total of 26 patients with inferior RDs secondary to one or more breaks between the 4 o'clock and 8 o'clock meridians were included from September 2007 to February 2012.

Results: The mean follow-up duration was 35.3 weeks. Anatomical success at 8 weeks was achieved in 65.4% of all patients (including those with giant retinal tear and patients with previous RD in the study eye). When excluding patients with giant retinal tear and previous RD in the study eye, the anatomical success rate increased to 70%. Overall, the mean visual acuity improved from 1.00 logMAR (Snellen equivalent 20/200) at baseline to 0.38 logMAR (Snellen equivalent 20/50) at last follow-up.

Conclusion: Sequential pneumatic retinopexy offers a new viable surgical option for the treatment of RDs secondary to inferior breaks.

This study evaluated a new approach of sequential pneumatic retinopexies for the management of inferior rhegmatogenous retinal detachments with inferior breaks. Anatomical success at 8 weeks was achieved in 65.4% of patients. In conclusion, sequential pneumatic retinopexy offers a new viable surgical option for the treatment of retinal detachments secondary to inferior breaks.

*Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada;

Département d'Ophtalmologie et ORL–Chirurgie cervico-faciale, Université Laval, Québec, Canada;

Newcastle Eye Centre, Royal Victoria Infirmary, Newcastle upon Tyne, United Kingdom;

§Department of Ophthalmology, St. Michael's Hospital, Toronto, Ontario, Canada; and

Department of Ophthalmology and Vision Sciences, The John and Liz Tory Eye Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.

Reprint requests: Peter J. Kertes, MD, CM, FRCSC, Department of Ophthalmology and Vision Sciences, The John and Liz Tory Eye Centre, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Room M1-202A, Toronto, Ontario, Canada, M4N 3M5; e-mail: peter.kertes@sunnybrook.ca

None of the authors has any financial/conflicting interests to disclose.

© 2018 by Ophthalmic Communications Society, Inc.