0521779407-18 CUNY1086/Karliner 0 521 77940 7 June 13, 2007 8:1
1298 Rhegmatogenous Retinal Detachment■Pneumatoretinopexy –
➣A small expansile gas bubble is injected into the vitreous cavity
after cryoretinopexy around breaks.
➣For partial or complete retinal detachments with retinal breaks
in the superior portion of the retina.
➣Requires patient to position head so that bubble covers break for
5–7 days.
■Scleral Buckle –
➣A silicon rubber explant is sutured on to the external scleral wall
in a way that causes the wall to buckle inward, thus forcing the
internal eye wall up against the detached retina.
➣Performed in conjunction with cryoretinopexy with or without
subretinal fluid drainage.
➣For partial or complete retinal detachment. Works well for infe-
rior or multiple retinal breaks.
■Vitrectomy –
➣Internal surgery whereby vitreous is removed and the retina repo-
sitioned. Vitreous is replaced by gas that dissipates on its own.
Performed in conjunction with laser or cryoretinopexy and scle-
ral buckling.
➣For retinal detachments with multiple or giant tears, vitre-
ous hemorrhage, cataract, inflammation, Proliferative vitreo-
retinopathy, or other complicating factors.
➣Requires head positioning 7–10 days.
follow-up
■Initially daily, then weekly, and then monthly in postop period.
■Yearly once stable.complications and prognosis
Complications
■Astigmatism or myopic shift – expected,
➣Get new glasses (6 mo postop).
■Cataract progression – expected with Vitrectomy.
➣Cataract surgery.
■Glaucoma (transient) – common.
➣Eye drops or oral meds (i.e., Diamox).
■Recurrent detachment – common till 2 mos., extremely rare after 6
mos.
➣Surgery.