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April 1989

Failed Retinal Detachment Repair After Intravitreal Air Injection

Arch Ophthalmol. 1989;107(4):487-488. doi:10.1001/archopht.1989.01070010501009

To the Editor.  —In the January 1988 issue of the Archives, Lewen and Eifrig1 described a patient with a subclinical retinal detachment who was treated with an intravitreal injection of room air. Despite a large injection volume of 0.75 mL, internal tamponade was judged inadequate six hours following the procedure. A second injection of air was undertaken, but multiple fish-egg bubbles occurred and a small air bubble was trapped in the subretinal space. Because the macula was "threatened," the patient underwent a scleral buckling procedure with encircling and circumferential elements, external drainage of subretinal fluid, injection of air, and postoperative positioning.The authors termed the initial procedure "pneumatic retinopexy." As described by Hilton and Grizzard,2 pneumatic retinopexy utilizes an intravitreal injection of an expansile gas, such as sulfur hexafluoride or perfluoropropane, to create an internal tamponade. External cryopexy or laser photocoagulation is then applied to create a chorioretinal

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