Additional Pneumatic Retinopexy in Patients with Persistent Retinal Detachment After Scleral Buckling

Purpose: To investigate the efficacy, safety, and indications for additional pneumatic retinopexy (PR) in patients with persistent retinal detachment (RD) after scleral buckling (SB). Methods: This retrospective study included patients who underwent additional PR after SB for primary rhegmatogenous RD (n = 78). We defined “inadequate buckle” as RD persistence due to low buckle height despite accurate buckle placement and “buckle misplacement” as an uncovered tear because of incorrect buckle placement. Results: The anatomical success rate after additional PR was 52.6%. Development of proliferative vitreoretinopathy (PVR) grade B (hazard ratio [HR], 5.73; P <0.001) and inferior retinal tears (HR, 2.12; P = 0.040) were significant risk factors for anatomical failure. The most common cause of anatomical failure was PVR (19/37; 51.4%), and epiretinal membrane formation was a common complication after additional PR (22/78; 28.2%). The anatomical success rate with additional PR was significantly higher in the inadequate buckle group than in the misplacement group (8/9 [88.9%] vs. 12/28 [42.9%]; P = 0.023) Conclusion: Development of PVR grade B and inferior retinal tears were significantly associated with anatomical failure after additional PR. Additional PR may benefit patients with superior retinal tears or low buckle height and those without PVR.