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Mechanism of Retinal Reattachment in Pneumatic Retinopexy

Some outcomes following pneumatic retinopexy (PnR) may be superior to pars plana vitrectomy (PPV) for managing rhegmatogenous retinal detachment, based on randomized clinical trial findings.

This animation video illustrates a possible mechanism for the difference in visual acuity outcomes between the 2 procedures based on observations of photoreceptor integrity on spectral-domain optical coherence tomography (OCT) after 12 months.

PnR involves injection of a gas bubble into the vitreous cavity that exerts minimum buoyant forces on the retina, potentially allowing the retinal pigment epithelium (RPE) pump to reabsorb the subretinal fluid and the photoreceptors to interdigitate. The photoreceptor layer re-apposition to the RPE may be more optimal, with less photoreceptor cell death, better visual acuity outcomes, and no visible discontinuities of the ellipsoid zone (EZ) and external limiting membrane (ELM) on OCT imaging compared with PPV repair.

Click the Related Multimedia link for a parallel video illustration of retinal reattachment following PPV repair and the Related Article link for full details.

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