Philippe Koch_SCIENTIFIC POSTER 2015_2


To present the case of a patient who developed a RRD recurrence after a pneumo-retinopexy (cryogas) that has been treated with Argon laser and a simple positioning.

Case Report:

A 59 y.o. woman presented for a RE Macula ON Rhegmatogenous Retinal Detachment with a limited detachment extending from 9 to 11 o’clock and a single retinal tear at 10 o’clock. She was thus treated with a pneumo-retinopexy procedure including the application of a cryocoagulation on the break and an endotamponade with SF6 0.5cc associated to a normalisation of intraocular pressure. The patient was asked to remain in position to allow a good support of the break during the first postoperative days and she was examined at day 1, 7, and 21 to confirm the disappearance of the subretinal fluid (SRF) and a good coagulation of the break. However, 6 weeks later, the patient presented at a programed follow-up with a recurrence in the extreme periphery of a thin wave of SRF extending from 8 to the margin of the cryocoagulation at 10 o’clock. No break was visible but the inferior margin of the cryo seemed to atrophic, probably hiding a little hole secondary to the cryocoagulation procedure itself in this area. One week later, the SRF extended from 7 to 10 o’clock, thus demonstrating a progression of this RD. Since a very thin wave of SRF was present associated to a thick vitreous, it was proposed to the patient to simply play with RPE pumps and the gravity to try to avoid a second surgery. Thus, a session of Argon laser was performed in consultation and the patient was asked to lie on her right side for 7 days. One week later, the patient presented at a new follow-up and SRF was totally absorbed whereas laser impacts had disappeared. At day 21, the patient had evident laser burns in the desired area with a fully attached retina.

In Conclusion:

Playing with RPE pump associated to an appropriate positioning using vitreous gravity allowed.

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