Pars plana vitrectomy with or without intraoperative 360° peripheral endolaser for rhegmatogenous retinal detachment treatment
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The aim of this study was to investigate whether intraoperative 360° prophylactic endolaser photocoagulation is necessary for the treatment of uncomplicated retinal detachment.
This prospective, randomized, comparative and interventional study includes 50 consecutive patients with primary rhegmatogenous retinal detachment (RRD) who were treated by pars plana vitrectomy. The patients were divided into two groups: in Group A endolaser applied to all existing breaks as well as a 360° laser retinopexy, while Group B received endolaser only to the retinal breaks. Primary anatomical success rate, a final best-corrected visual acuity (BCVA) and postoperative complications were analyzed and compared between the groups at 1 and 3 months.
After the primary procedure, the retina was reattached in 96% (24 of 25) of patients in Group A and in 88% (22 of 25) of patients in Group B at 1 and 3 months. The mean final BCVA (logarithm of the minimum angle of resolution) improved from 1.26 to 0.52 in Group A with 17 cases (68%) macula-off and 1.19 to 0.77 in Group B with 18 cases (72%) macula-off at preoperative and final follow-up visit. Epiretinal membranes were seen in four cases in Group A and four cases in Group B at 3 months. No statistically significant difference in the anatomical, functional and complication outcomes between the two groups was recorded.
Pars plana vitrectomy without the 360° peripheral endolaser can provide successful anatomic outcomes and functional improvement in uncomplicated primary RRDs.
Keywords360° Endolaser Peripheral endolaser Primary rhegmatogenous Retinal detachment Vitrectomy
Compliance with ethical standards
Conflict of interest
The authors declares no conflict of interest and no relevant financial relationships to disclose.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
- 1.Bardbury MJ, Landers MB (2001) Pathogenetic mechanisms of retinal detachment. In: Ryan SJ, Wilkinson CP (eds) Retina, 1987–1993. Mosby, St LouisGoogle Scholar
- 9.Weichel ED, Martidis A, Fineman MS, McNamara JA, Park CH, Vander JF, Ho AC, Brown GC (2006) Pars plana vitrectomy versus combined pars plana vitrectomy-scleral buckle for primary repair of pseudophakic retinal detachment. Ophthalmology 113(11):2033–2040. https://doi.org/10.1016/j.ophtha.2006.05.038 CrossRefPubMedGoogle Scholar
- 13.Iwase T, Jo YJ, Oveson BC (2013) Effect of prophylactic 360 degrees laser treatment for prevention of retinal detachment after phacovitrectomy: (prophylactic 360 degrees laser treatment for prevention of retinal detachment). BMC Ophthalmol 13:77. https://doi.org/10.1186/1471-2415-13-77 CrossRefPubMedPubMedCentralGoogle Scholar
- 16.Zhou C, Qiu Q (2015) 360 Degrees versus localized demarcation laser photocoagulation for macular-sparing retinal detachment in silicone oil-filled eyes with undetected breaks: a retrospective, comparative, interventional study. Lasers Surg Med 47(10):792–797. https://doi.org/10.1002/lsm.22430 CrossRefPubMedGoogle Scholar
- 18.Romano MR, Angi M, Valldeperas X, Costagliola C, Vinciguerra P (2011) Twenty-three-gauge pars plana vitrectomy, Densiron-68, and 360 degrees endolaser versus combined 20-gauge pars plana vitrectomy, scleral buckle, and SF6 for pseudophakic retinal detachment with inferior retinal breaks. Retina (Philadelphia, Pa) 31(4):686–691. https://doi.org/10.1097/iae.0b013e3181f0d249 CrossRefGoogle Scholar