Causes of failure of pneumatic retinopexy
Roberto E. Flaminiano, MD, Robert T. Sy, MD, Milagros H. Arroyo, MD, Pearl Tamesis-Villalon, MD
Objective
To determine the causes of failure in eyes that underwent pneumatic retinopexy at the University of the Philippines-Philippine General Hospital (UP-PGH).
Methods
A retrospective review of pneumatic retinopexy procedures performed at the UP-PGH from January 1996 to December 2002 was undertaken. Seventeen cases were analyzed as to preoperative and intraoperative variables: age; sex; preoperative visual acuity; presence of proliferative vitreoretinopathy(PVR); extent of retinal detachment; presence of macular detachment; presence, number, and type of lattice degeneration; previous cataract surgery; surgeon factor; and intraoperative use of cryotherapy. Two-tailed Fisher’s exact test and Chi square test were used in the analysis of statistical significance.
Results
The following variables were shown to be significantly correlated with failure: eyes with breaks outside the 11-1 o’clock meridians (p = 0.02), eyes with less than or equal to 3 quadrants of retinal detachment (p = 0.05), and preoperative visual acuity worse than 5/60 (p < 0.100).
Conclusion
Failure in eyes with retinal breaks outside the 11-1 o’clock meridians suggested poor patient compliance with regard to postoperative posture. In eyes with less than or equal to three quadrants of detachment, failure may ensue as a result of spillover of subretinal fluid to uninvolved quadrants. Future success with pneumatic retinopexy will rely ultimately on careful patient selection, surgeon familiarity with the technique, and patient cooperation.
Key words: Pneumatic retinopexy, Retinal detachment, Proliferative vitreoretinopathy