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Comment & Response
October 2013

Complications of Pneumatic Retinopexy

Author Affiliations
  • 1Department of Ophthalmology, Geneva University Hospitals, Geneva, Switzerland
JAMA Ophthalmol. 2013;131(10):1370. doi:10.1001/jamaophthalmol.2013.4590

To the Editor The report by Fabian and colleagues1 of outcomes in 258 cases of pneumatic retinopexy (PR), in our opinion, does not support their conclusion that “with proper selection of cases PR is a good surgical option for primary RRD [rhegmatogenous retinal detachment].”1 In their series of selected RRD cases with relatively good prognosis, “a single surgery anatomical success was achieved in only 158 eyes (61.2%).”1 The authors note final anatomical success in 99.2%, but the rate of complications is impressively high for a series of RRDs with favorable prognosis: 2% macular hole, 13% epiretinal membrane, 3.4% proliferative vitreoretinopathy, 5.4% with silicone oil (4 eyes’ second operation and 10 eyes with >2 operations), and 4.7% late redetachment. The 258 initial PRs were followed by 126 reoperations. Relatively high reoperation and complication rates are supported by the literature.2-4 Scleral buckling for “simple” cases has a much lower complication rate and should be the operation of choice under normal circumstances, or alternatively vitrectomy should be used.5

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