A 46-year-old phakic man presents with a fresh superior rhegmatogenous retinal detachment. Examination shows two small horseshoe tears located between 10 and 1 o'clock, clear media, and a detached but mobile macula still attached. He cannot undergo surgery for two days. Which intervention is the most appropriate immediate option?

• A Observation with strict bed rest until scheduled buckling surgery
• B Pneumatic retinopexy with intravitreal gas and cryotherapy ✓
• C Immediate pars plana vitrectomy as an emergency procedure
• D Panretinal photocoagulation to wall off the detachment

Explanation

This patient fits the classic profile for pneumatic retinopexy: phakic eye, clear media, single or clustered superior breaks within the 8 to 4 o'clock zone, and no PVR. An expansile gas bubble tamponades the tears immediately, buying time or serving as definitive care combined with cryoretinopexy. Laser demarcation (option D) is inadequate for an actively progressing detachment, and emergency vitrectomy is unnecessary when anatomy suits office-based gas tamponade.

Reference: Kanski's Clinical Ophthalmology, 9th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.