To the Editor.
—We read with interest the article by Smiddy et al, in the October 1989 issue of the Archives. We agree with the authors that an encircling element frequently results in increased axial length and induced myopia and that a radial buckle infrequently results in significant postoperative refractive change. We take exception to their concluding comment, which stated that "this study was not designed to compare pneumatic retinopexy with scleral buckling, but candidates for pneumatic retinopexy can usually be treated with a radial scleral buckle." We would like to point out that several studies have shown pneumatic retinopexy to be effective for complicated retinal detachments involving multiple breaks in multiple quadrants and large tears exceeding 30°.2,3 These cases, if treated with scleral buckling techniques, usually require an encircling element.The Pneumatic Clinical Trial4 addressed retinal detachments secondary to a break(s) within 30°. Although these cases could
Tornambe PE, Hilton GF. Pneumatic Retinopexy and Buckling. Arch Ophthalmol. 1990;108(3):318–319. doi:10.1001/archopht.1990.01070050016003
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