Subretinal gas after pneumatic retinopexy can be managed with vitrectomy

Pneumatic retinopexy complicated by subretinal gas can be repaired using vitrectomy with perfluorocarbon liquid injection and fluid/gas exchange, according to a case study.

Julie Chen and colleagues at the Massachusetts Eye and Ear Infirmary described the case of a 60-year-old woman who presented with a horseshoe retinal tear and associated retinal detachment. Ten years earlier, she had undergone laser retinopexy in the same eye. She was treated this time with pneumatic retinopexy. Cryopexy was applied to the retinal breaks and 0.3 cc of 100% perfluoropropane was injected 4 mm posterior to the limbus. The procedure was complicated by multiple small gas bubbles that migrated under the retina.

To remove the subretinal gas, a vitrectomy was performed, along with injection of perfluorocarbon liquid.

One week postop, fundus examination revealed an attached retina with 80% - 90% gas fill and no subretinal gas remaining, the authors of the case report said. At 11 weeks postop, visual acuity was 20/125, improving to 20/40 with pinhole. Five months after initial presentation, the patient underwent uncomplicated phaco with posterior chamber IOL implantation.

The full case study is published in the Digital Journal of Ophthalmology.