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November 1990

Causes of Proliferative Retinopathy Following Pneumatic Retinopexy

Author Affiliations

Sunderland, England

Arch Ophthalmol. 1990;108(11):1515. doi:10.1001/archopht.1990.01070130017003

To the Editor.  —The article by Hackett et al1 in the March 1989 issue of the Archives has serious implications for the technique of pneumatic retinopexy. With this technique, an expanding gas bubble causes retinal flattening by a combination of the surface tension of the bubble, preventing recruitment of fluid from the vitreous cavity through the retinal hole, and the bubble squeezing subretinal fluid through the open break. The latter is sometimes deliberately encouraged by performing "steamroller maneuvers." As a result of subretinal fluid being squeezed through the break, a marked increase in vitreous flare and pigment cells can be observed.2 On one occasion, we have observed pigment cells being squeezed through an open break using the slit lamp with a 90-diopter lens.This dumping of subretinal fluid into the vitreous cavity is unique to pneumatic retinopexy; in conventional retinal detachment surgery, the subretinal fluid becomes isolated from the

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