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Primary Retinal Detachment

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Table 4.3. Required materials<br />

4 Pneumatic Retinopexy for <strong>Primary</strong> <strong>Retinal</strong> <strong>Detachment</strong><br />

Anesthetic of choice<br />

Povidone–iodine 5% solution<br />

Eyelid speculum and caliper<br />

Several sterile cotton-tip applicators<br />

1-ml syringe/30-gauge needle – plunger removed (if paracentesis)<br />

Gas cylinder/tubing<br />

Millipore filter<br />

1-ml or 3-ml syringe/30-gauge needle<br />

Cryotherapy unit or laser<br />

Antibiotic/steroid combination ointment<br />

Patch materials<br />

Table 4.4. Pneumatic retinopexy technique steps<br />

Apply anesthetic of choice<br />

Prepare eye – povidone–iodine 5% – 5 min ¥2<br />

Prepare chosen gas<br />

Place eyelid speculum<br />

Perform cryopexy (one-step procedure)<br />

Paracentecis (surgeon’s choice)<br />

Position patient, head<br />

Caliper measurement – 4 mm<br />

Inject gas bubble/location<br />

Inspect gas location, central retinal artery perfusion<br />

Check intraocular pressure until normalizes<br />

Patch with arrow drawn<br />

Laser (next day, if two-step procedure)<br />

by topical, subconjunctival, peribulbar, or retrobulbar routes. A<br />

retrobulbar or parabulbar injection is given when cryopexy is<br />

planned, while topical or subconjunctival administration is sufficient<br />

for gas injection alone. The globe, eyelids, and periocular skin<br />

are prepared with a 5% povidone–iodine solution applied twice at<br />

5-min intervals. Some surgeons choose to add a topical antibiotic

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