Long-term Anatomical and Visual Success of Pneumatic Retinopexy in Sequential Bilateral Giant Retinal Tears: A 20-Year Follow-up Case Report

This case report presents a rare case of sequential bilateral giant retinal tears (GRTs) successfully managed with pneumatic retinopexy, highlighting the long-term anatomical and visual outcomes. A 43-year-old woman with a history of mild myopia and bilateral pseudophakia developed a superior temporal GRT in the left eye in 2005 and a similar tear in the right eye in 2010. Both eyes were treated with pneumatic retinopexy using intravitreal sulfur hexafluoride gas injection, followed by laser photocoagulation. The patient was monitored regularly for 20 years. Complete retinal reattachment was achieved in both eyes without the need for pars plana vitrectomy. Best-corrected visual acuity remained 20/20 bilaterally throughout the follow-up period. No recurrence or secondary complications were observed. Although pars plana vitrectomy is typically the preferred treatment for GRTs, this case demonstrates that, in carefully selected patients, pneumatic retinopexy can be a viable and durable alternative even in the context of bilateral GRTs. The 20-year follow-up underscores the long-term effectiveness and safety of this less invasive approach.