Modified pneumatic retinopexy with endoillumination for management of recurrent retinal detachment after failed scleral buckle

We report a modification of pneumatic retinopexy (PnR), incorporating endoillumination, for management of recurrent rhegmatogenous retinal detachment (RRD) after scleral buckle (SB). A 42-year-old gentleman underwent SB for treatment of left-eye RRD without macular involvement and not associated with posterior vitreous detachment. Preoperative best-corrected visual acuity (BCVA) was 6/12 in the left eye. Recurrence of RRD was noted at 1 month postoperatively, and the patient elected to undergo a modified rescue PnR, where endoillumination was adopted. BCVA improved to 6/9.5, and complete resolution of subretinal fluid was observed at 1 month postoperatively. There were no intraoperative complications, and there was no recurrence of RRD at 1-year follow-up. We conclude that modified rescue PnR with endo-illumination represents a safe and effective method to manage failed primary RRD following SB. It offers the advantage of enhancing the visualization of new or missed retinal breaks and represents a less invasive surgical approach when compared to revision SB or PPV.