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Pneumatic retinopexy in the treatment of rhegmatogenous retinal detachment- our experience

Session Details

Session Title: Miscellaneous

Session Date/Time: Saturday 13/09/2014 | 11:00-13:00

Paper Time: 12:36

Venue: Boulevard E

First Author: : T.Painhas PORTUGAL

Co Author(s): :    M. Ruão   R. Soares   C. Manso   A. Gomes da Rocha   J. Chibante-Pedro  

Abstract Details

Purpose:

This study aimed to evaluate the long-term anatomical and functional outcome of pneumatic retinopexy (PR) in rhegmatogenous retinal detachment (RRD) as well as the factors that influence the success of the procedure. The procedure consists in the injection of gas into the vitreous cavity, combined with cryotherapy or laser retinopexy, then positioning the patient's head. PR is a simple, minimally invasive procedure for RRD. Compared with scleral buckling or vitrectomy, pneumatic retinopexy provides a less invasive and often better-tolerated therapeutic alternative.

Setting:

Ophthalmology Department of Centro Hospitalar entre o Douro e Vouga, Santa Maria da Feira, Portugal.

Methods:

We review the management by pneumatic retinopexy of 83 cases of RRD performed between a period of twelve years at Centro Hospitalar de Entre o Douro e Vouga with a minumim follow up of one year.

Results:

The mean age of patients was 60,7. Final reattachment of the retina was achieved in 89% of the cases. In 73% of cases, the primary intervention was successful. However, the retina redetached in 15% of these during the first 3 months, requiring reinjection or another procedure. Before PR, 46.1% of the patients had visual acuity (VA) of 0.1 or worst, while only 27.5% had VA better than 0.4. After the procedure 65.7% of patients reached a VA of 0.4 or better. Factors that significantly influence (p<0.05) single operation success (SOS) include phakia, macula state at the presentation, extent of retinal detachment and time between the beginning of the symptoms and the procedure. A subgroup of patients with the following criteria: phakic eyes, only one quadrant of retinal detachment, and only one retinal break located in the upper two-thirds of the fundus had a SOS rate of 97%. Among other factors, the most important ones that influence visual recovery positively seem to be better pre-operative visual acuity, preoperatively attached macula and duration of macular detachment less than 8 days. The most common postoperative complications were cataract formation, hemovitreous or development of proliferative vitreoretinopathy.

Conclusions:

Final successful anatomical retinal reattachment was obtained in 89% of the cases and sixty one percent of the cases obtained long-term retinal reattachment with a single procedure with good visual recovery and less morbidity than other more invasive procedures like scleral buckling or pars plana vitrectomy, translating to higher productivity for the patien. Factors such as phaquic state and the state of the macula at presentation seem to influence the success of RP. This procedure, being faster than the alternatives, saves time, making RP a good option in selected DRR.

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