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April 1989

Failed Retinal Detachment Repair After Intravitreal Air Injection-Reply

Author Affiliations

Chapel Hill, NC

Arch Ophthalmol. 1989;107(4):488. doi:10.1001/archopht.1989.01070010501010

In Reply.  —We thank Poliner and Tornambe for their interest in our case report, and we appreciate their suggestions and caveats regarding pneumatic retinopexy. This procedure has been modified somewhat since Rosengren,1 in 1938, achieved a 77% success rate in the repair of almost 260 retinal detachments using diathermy, drainage of subretinal fluid, and intravitreal injection of 1.5 to 2.0 mL of air. Recently, the introduction of long-acting expansile gases such as sulfur hexafluoride and perfluoropropane have been utilized to create the internal gas tamponades. Nevertheless, as shown by Rosengren 50 years ago, the use of intravitreal room air can be quite successful in repairing retinal detachments via pneumatic retinopexy techniques.Poliner and Tornambe caution that the injection of large volumes of air may cause significant vitreous displacement and induce tractional forces within the vitreous, thereby significantly increasing the risk of new retinal tears in the early postoperative period.

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