Recent advances in management of rhegmatogenous retinal detachment

Abstract

A rhegmatogenous retinal detachment occurs due to a break in the retina that allows fluid to pass from the vitreous space into the subretinal space. So treatment of a case of RRD depends on sealing of that break and absorption of subretinal fluid. Surgical strategies should be individualized based on a variety of factors. These should include the number, size, and location of the retinal breaks; the extent of the traction exerted on the retina; the lens status; the patient's expected ability to comply with postoperative positioning requirements; the available operating room equipment and support staff; the experience and preferences of the surgeon; and the preferences of the patient and caregivers. Using these guidelines, and the surgeon's best clinical judgment, anatomic reattachment and favorable visual outcomes are achievable for the vast majority of patients with primary rhegmatogenous RD. One of these surgical strategies is pneumatic retinopexy which is a 2-step procedure. In the first step, an expanding gas bubble is injected into the vitreous cavity and the patient is positioned so that the bubble closes the retinal break, permitting resorption of subretinal fluid. The second step entails induction of a chorioretinal adhesion around all retinal breaks with cryopexy, laser, or both. And In general, the best candidates for pneumatic retinopexy are those who have a single retinal break or group of retinal breaks that are not larger than 1 clock hour (30°) and that are located in the superior 8 clock hours of the globe. Furthermore, the patient must have the ability to maintain a proper head position for at least 16 hours per day for 5 days or more.