Pneumatic Retinopexy for Rhematogenous Retinal Detachment

This video demonstrates the steps for performing a pneumatic retinopexy to repair primary rhegmatogenous retinal detachment (RRD). After administering subconjunctival lidocaine, an anterior chamber paracentesis (AC tap) is performed to remove as much fluid as possible. A mark is made approximately 4 mm posterior to the limbus. The surgeon slowly injects 100% sulphur hexafluoride gas (SF6), 0.3 cc more than the AC tap volume for a minimum of 0.6 cc. The optic nerve should be examined to check the central retinal artery perfusion and to visualize the gas bubble. A repeat AC tap should be performed as needed. 

Findings from the 1-year PIVOT trial comparing functional and anatomic outcomes of pneumatic retinopexy versus pars plana vitrectomy for the management of primary RRD is available online in Ophthalmology. Dr. Rajeev Muni discusses the PIVOT trial outcomes in this interview from ASRS 2017.

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