Retinopexy for Retinal Tears and Pneumatic Retinopexy for Primary Retinal Detachment

Retinal breaks are precursors of rhegmatogenous retinal detachment (RRD). There are several different types of retinal breaks with variable risks of progression to RRD. Those associated with a high risk of progression to retinal detachment should be treated with retinopexy. Pneumatic retinopexy is a simple minimally invasive in-office procedure that is used for fixing certain types of retinal detachment. It involves paracentesis, injection of an undiluted gas bubble into the vitreous cavity, and postoperative positioning. Retinopexy may be performed prior to or after gas injection by using cryotherapy or laser, respectively. Careful preoperative examination and patient selection are of paramount importance in achieving successful surgery. Although pneumatic retinopexy is associated with a lower anatomical success rate compared to pars plana vitrectomy and scleral buckle, it is considered as the most physiological technique to treat rhegmatogenous retinal detachment and is associated with superior functional results. This chapter outlines the management of different types of retinal breaks and indications, techniques, limitations, and complications of pneumatic retinopexy.