Comparison of Anatomical and Functional Outcomes of Laser Photocoagulation and Cryopexy in Patients with Rhegmatogenous Retinal Detachment Treated with Pneumatic Retinopexy

This study will include 40 patients with rhegmatogenous retinal detachment with one or more retinal breaks within two clock hours, limited to the upper half of the retina, who will be treated with pneumatic retinopexy. The patients will be thoroughly informed about the surgical procedure and the risks of potential complications. After a detailed clinical examination and the selection of suitable patients for this surgical method, the chosen patients will be randomized into two groups. In the first group, patients will undergo transscleral cryopexy at the site of the retinal break (retrobulbar anesthesia will be given), guided by indirect ophthalmoscopy, during the same procedure. In the second group, after retinal reattachment, laser photocoagulation will be performed. Before insufflation of the gas in the vitreous cavity, paracentesis of the anterior chamber will be performed to prevent increased intraocular pressure (0.2 mL of fluid will be withdrawn from the anterior chamber, with a 30-gauge needle). In both groups, patients will receive sulfur hexafluoride gas (SF6) in the vitreous space (0.5 mL). The gas will be injected with a 30-gauge needle, 3.5 or 4 mm from the corneal limbus (depending on the lens status: phakic/pseudophakic), at a moderate pace to avoid the formation of numerous little bubbles - a "fish eggs" phenomenon. Afterwards, evaluation of IOP will be performed by carefully evaluation of the central retinal artery for perfusion and confirmation of the light perception. All patients will receive postoperative topical therapy with a combination of antibiotics and corticosteroids, and their head positioning will be adjusted according to the location of the retinal break(s) (positioned opposite to the retinal break for 5-8 days post-surgery, for 16 hours a day). Patients will receive appropriate hospital care and will be followed up in the retinal disease clinic postoperatively.