Primary Retinal Detachment

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minimally invasive nature. There is little pain, more rapid return of
vision, and fewer postoperative complications, resulting in a more
expedient return to daily activities. For the surgeon, the procedure
is quick, technically easy, and performed in the outpatient or office
setting. These advantages, combined with the procedure’s low cost,
have led to increased interest and usage of PR for the treatment of
primary RRD.
Technique
Pneumatic retinopexy consists of several key elements, including
proper preoperative patient and case selection, gas injection, laser
or cryopexy, and postoperative positioning.
Patient Selection
4 Pneumatic Retinopexy for Primary Retinal Detachment
The use of PR demands a high degree of patient understanding
and compliance in order to succeed. The most frequent cause of
failed closure of the primary break(s) is inadequate tamponade
due to patient non-compliance.As a result, the patient must be able
to understand the vital role of bubble positioning during the
early postoperative course. The surgeon should take extra care
educating the patient preoperatively about the desired head position.
Taking the patient’s head in his/her hands and turning or
tilting it to the proper orientation is frequently helpful. Involving
accompanying family or friends in the discussion may reinforce
the message. Physically, the patient must be able to comply. Those
with arthritis, neck or back problems, or other physical constraints
are less desirable candidates for PR. In general, a young, bright,
highly motivated individual is the best candidate for the PR
technique.