Causes of failure of pneumatic retinopexy

Abstract

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.