title: Characterization of pneumatic retinopexy failures and the pneumatic pump: a new complication of pneumatic retinopexy.
abstract: BACKGROUND
  We review a three-year series of cases with pneumatic retinopexy (PR), specifically evaluating failures and suggesting a new mechanism of failure.
  
  
  METHODS
  One hundred and thirty-five consecutive patients who underwent PR for rhegmatogenous retinal detachments were included. The primary outcome measure was the characteristics of PR failures. Secondary outcome measures included preoperative clinical characteristics.
  
  
  RESULTS
  Seventy-five percent of the patients had successful results with PR; 100% were ultimately reattached with additional surgery. All but 1 failure (97%) occurred within the first postoperative month and 85% occurred by postoperative Day 10. The most common cause of failure was a new detachment from a new break (23 of 35 failures). Risk factors for failure included presenting visual acuity worse than 20/60 (odds ratio [OR] = 1.89), male gender (OR = 1.52), age >60 years (OR = 1.32), >2 breaks (OR = 1.28), pseudophakia/aphakia (OR = 1.20), and detachments after trabeculectomy (OR = 2.43). Lattice degeneration, high myopia (>-6.00 diopters), left eye, detachment after cataract surgery or yttrium aluminum garnet capsulotomy had minimal influence on outcome (all OR < 1.10).
  
  
  CONCLUSIONS
  Characterization of PR failures will improve patient selection. We have named a new complication secondary to a patient performing the steamroller maneuver five times the "pneumatic pump."
authors.affiliation: *Department of Ophthalmology, University of California, San Francisco, San Francisco, California; and †Charles T. Campbell Ocular Microbiology Laboratory, UPMC Eye Center, Retina Service, Department of Ophthalmology, University of Pittsburgh School of Medicine and The Eye and Ear Institute, Pittsburgh, Pennsylvania.
authors.forename: Ian R
authors.initials: IR
authors.lastname: Gorovoy
authors.forename: Andrew W
authors.initials: AW
authors.lastname: Eller
authors.forename: Thomas R
authors.initials: TR
authors.lastname: Friberg
authors.forename: Rodney
authors.initials: R
authors.lastname: Coe
mesh_terms: D000368:Aged; D003452:Cryosurgery / Q000009:adverse effects*; D058450:Endotamponade / Q000009:adverse effects*; D005260:Female; D005466:Fluorocarbons; D005500:Follow-Up Studies; D006801:Humans; D053685:Laser Therapy / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012163:Retinal Detachment / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery*; D012167:Retinal Perforations / Q000209:etiology; D012307:Risk Factors; D013459:Sulfur Hexafluoride; D017211:Treatment Failure; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology
chemical_list: D005466:Fluorocarbons; C042852:perflutren; D013459:Sulfur Hexafluoride