Advertisement

Pars plana vitrectomy with or without intraoperative 360° peripheral endolaser for rhegmatogenous retinal detachment treatment

  • Ahmet Burak Bilgin
  • Mehmet Erkan Dogan
  • Basak Aysun
  • Kadri Cemil Apaydın
Original Paper
  • 41 Downloads

Abstract

Purpose

The aim of this study was to investigate whether intraoperative 360° prophylactic endolaser photocoagulation is necessary for the treatment of uncomplicated retinal detachment.

Methods

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.

Results

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.

Conclusions

Pars plana vitrectomy without the 360° peripheral endolaser can provide successful anatomic outcomes and functional improvement in uncomplicated primary RRDs.

Keywords

360° Endolaser Peripheral endolaser Primary rhegmatogenous Retinal detachment Vitrectomy 

Notes

Compliance with ethical standards

Conflict of interest

The authors declares no conflict of interest and no relevant financial relationships to disclose.

Ethical approval

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

Informed consent was obtained from all individual participants included in the study.

References

  1. 1.
    Bardbury MJ, Landers MB (2001) Pathogenetic mechanisms of retinal detachment. In: Ryan SJ, Wilkinson CP (eds) Retina, 1987–1993. Mosby, St LouisGoogle Scholar
  2. 2.
    Vaziri K, Schwartz SG, Kishor KS, Flynn HW Jr (2016) Tamponade in the surgical management of retinal detachment. Clin Ophthalmol (Auckland, NZ) 10:471–476.  https://doi.org/10.2147/opth.s98529 CrossRefGoogle Scholar
  3. 3.
    Saw SM, Gazzard G, Wagle AM, Lim J, Au Eong KG (2006) An evidence-based analysis of surgical interventions for uncomplicated rhegmatogenous retinal detachment. Acta Ophthalmol Scand 84(5):606–612.  https://doi.org/10.1111/j.1600-0420.2006.00715.x CrossRefPubMedGoogle Scholar
  4. 4.
    SPR Study Group (2003) View 2: the case for primary vitrectomy. Br J Ophthalmol 87(6):784CrossRefGoogle Scholar
  5. 5.
    Schwartz SG, Flynn HW (2008) Pars plana vitrectomy for primary rhegmatogenous retinal detachment. Clin Ophthalmol (Auckland, NZ) 2(1):57–63CrossRefGoogle Scholar
  6. 6.
    Brazitikos PD, Androudi S, D’Amico DJ, Papadopoulos N, Dimitrakos SA, Dereklis DL, Alexandridis A, Lake S, Stangos NT (2003) Perfluorocarbon liquid utilization in primary vitrectomy repair of retinal detachment with multiple breaks. Retina 23(5):615–621CrossRefPubMedGoogle Scholar
  7. 7.
    Wickham L, Ho-Yen GO, Bunce C, Wong D, Charteris DG (2011) Surgical failure following primary retinal detachment surgery by vitrectomy: risk factors and functional outcomes. Br J Ophthalmol 95(9):1234–1238.  https://doi.org/10.1136/bjo.2010.190306 CrossRefPubMedGoogle Scholar
  8. 8.
    Arya AV, Emerson JW, Engelbert M, Hagedorn CL, Adelman RA (2006) Surgical management of pseudophakic retinal detachments: a meta-analysis. Ophthalmology 113(10):1724–1733.  https://doi.org/10.1016/j.ophtha.2006.05.044 CrossRefPubMedGoogle Scholar
  9. 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
  10. 10.
    Koh HJ, Cheng L, Kosobucki B, Freeman WR (2007) Prophylactic intraoperative 360 degrees laser retinopexy for prevention of retinal detachment. Retina 27(6):744–749.  https://doi.org/10.1097/iae.0b013e318030ebd7 CrossRefPubMedGoogle Scholar
  11. 11.
    Kreiger AE (1993) Wound complications in pars plana vitrectomy. Retina (Philadelphia, Pa) 13(4):335–344CrossRefGoogle Scholar
  12. 12.
    Adelman RA, Parnes AJ, Ducournau D (2013) Strategy for the management of uncomplicated retinal detachments: the European vitreo-retinal society retinal detachment study report 1. Ophthalmology 120(9):1804–1808.  https://doi.org/10.1016/j.ophtha.2013.01.070 CrossRefPubMedGoogle Scholar
  13. 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
  14. 14.
    Yang HS, Kim YJ, Kim JG (2016) New prophylactic intraoperative septated circumferential barrier laser in macular surgery. Can J Ophthalmol 51(2):102–107.  https://doi.org/10.1016/j.jcjo.2015.12.013 CrossRefPubMedGoogle Scholar
  15. 15.
    Laidlaw DA, Karia N, Bunce C, Aylward GW, Gregor ZJ (2002) Is prophylactic 360-degree laser retinopexy protective? Risk factors for retinal redetachment after removal of silicone oil. Ophthalmology 109(1):153–158CrossRefPubMedGoogle Scholar
  16. 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
  17. 17.
    Tufail A, Schwartz SD, Gregor ZJ (1997) Prophylactic argon laser retinopexy prior to removal of silicone oil: a pilot study. Eye (London, England) 11(Pt 3):328–330.  https://doi.org/10.1038/eye.1997.69 CrossRefGoogle Scholar
  18. 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
  19. 19.
    Falkner-Radler CI, Graf A, Binder S (2015) Vitrectomy combined with endolaser or an encircling scleral buckle in primary retinal detachment surgery: a pilot study. Acta Ophthalmol 93(5):464–469.  https://doi.org/10.1111/aos.12663 CrossRefPubMedGoogle Scholar
  20. 20.
    Figueroa MS, Contreras I, Noval S (2013) Anatomic and visual outcomes of 23-G vitrectomy without scleral buckling for primary rhegmatogenous retinal detachment. Eur J Ophthalmol 23(3):417–422.  https://doi.org/10.5301/ejo.5000234 CrossRefPubMedGoogle Scholar
  21. 21.
    Schneider EW, Geraets RL, Johnson MW (2012) Pars plana vitrectomy without adjuvant procedures for repair of primary rhegmatogenous retinal detachment. Retina (Philadelphia, Pa) 32(2):213–219.  https://doi.org/10.1097/iae.0b013e3182278b29 CrossRefGoogle Scholar
  22. 22.
    Barrada O, Nabih M, Khattabm A, Nosseir A (2015) Laser retinopexy in preventing retinal re-detachment after 23-gauge vitrectomy for primary repair of retinal detachment. Egypt Retina J 3(1):1–9.  https://doi.org/10.4103/2347-5617.179339 CrossRefGoogle Scholar
  23. 23.
    Ryan EH Jr, Mittra RA (2010) Scleral buckling vs vitrectomy: the continued role for scleral buckling in the vitrectomy era. Arch Ophthalmol 128(9):1202–1205.  https://doi.org/10.1001/archophthalmol.2010.192 CrossRefPubMedGoogle Scholar
  24. 24.
    Katira RC, Zamani M, Berinstein DM, Garfinkel RA (2008) Incidence and characteristics of macular pucker formation after primary retinal detachment repair by pars plana vitrectomy alone. Retina (Philadelphia, Pa) 28(5):744–748.  https://doi.org/10.1097/iae.0b013e318162b031 CrossRefGoogle Scholar
  25. 25.
    Chaturvedi V, Basham RP, Rezaei KA (2014) Scleral depressed vitreous shaving, 360 laser, and perfluoropropane (C3 F8) for retinal detachment. Indian J Ophthalmol 62(7):804–808.  https://doi.org/10.4103/0301-4738.138621 CrossRefPubMedPubMedCentralGoogle Scholar
  26. 26.
    Crafoord S, Algvere PV, Seregard S, Kopp ED (1999) Long-term outcome of RPE allografts to the subretinal space of rabbits. Acta Ophthalmol Scand 77(3):247–254CrossRefPubMedGoogle Scholar

Copyright information

© Springer Nature B.V. 2018

Authors and Affiliations

  • Ahmet Burak Bilgin
    • 1
  • Mehmet Erkan Dogan
    • 2
  • Basak Aysun
    • 1
  • Kadri Cemil Apaydın
    • 1
  1. 1.Department of OpthalmologyAkdeniz UniversityKonyaaltıTurkey
  2. 2.Department of OpthalmologyElmali State HospitalYeni Mahalle, ElmaliTurkey

Personalised recommendations