ADVANTAGES OF PR

Given an optimal clinical scenario, PR has several advantages over primary pars plana vitrectomy (PPV) and/or scleral buckle (SB) for the repair of an RRD. Pneumatic retinopexy is usually performed in the office or as a brief procedure in an outpatient surgical facility. In a multicentre trial reported by Tornambe,¹ the average number of hospital days including reoperations was 0.6 for the PR group and 2.7 for the SB group. The physician spends less time waiting for availability of the operating room, performing the procedure, and performing postoperative hospital rounds. It should be noted, however, that since this publication in 1989, the majority of procedures, including PR, primary PPV, and SB, are now performed in an outpatient setting.

With PR, the patient generally experiences less pain, and there is a quicker recovery in the more comfortable home setting. There is also a significant economic advantage to the patient and the insurer in terms of cost savings by avoiding the operating room, anaesthesia, and hospital expenses. It is estimated that the cost of PR is between 25% and 50% that of SB including re-operations.²

Pneumatic retinopexy is a technically easy procedure. There are very few significant intraoperative complications. When they do occur, it generally involves improper location of the injected air or gas, generally into the subconjunctival or subretinal space—in only 0–10% and 0–4% of cases.^1–7 New and/or missed retinal breaks are created in 7–33% of cases.^1–10

There are more significant risks associated with primary PPV and SB procedures. Primary PPV surgery has a much higher incidence of lens injury/cataract (3%) and other …