Advertisement

Treated retinal breaks: clinical course and outcomes

  • Robert B. Garoon
  • William E. Smiddy
  • Harry W. FlynnJr
Retinal Disorders

Abstract

Purpose

To report rates and timing of retreatments, new break formation, and vitreoretinal surgical intervention after initial treatment of retinal breaks, and to identify factors associated with increased rates of additional vitreoretinal interventions.

Methods

Retrospective, consecutive case series of all patients who were diagnosed with a retinal break and underwent laser retinopexy for prophylaxis of retinal detachment at the Bascom Palmer Eye Institute, Miami, FL, from 2013 through 2016 were reviewed. The main outcome measure was if additional laser treatment or vitreoretinal surgical procedure was performed after the initial laser retinopexy.

Results

Additional laser retinopexy was performed in 75 (18.7%) of 401 study eyes over 113 sessions: 58 (51.3%) sessions to retreat the original tear and 55 (48.7%) to treat a new tear. Vitreoretinal surgery for retinal detachment after the initial laser retinopexy was performed in 23 (5.7%) eyes. Risk factors associated with vitreoretinal surgery after initial laser treatment included superotemporal location (OR = 3.62; p = 0.008), vitreous hemorrhage (OR = 2.62; p = 0.017), and multiple breaks (OR = 2.60; p = 0.014).

Conclusions

Additional treatment is often performed after the initial treatment of a retinal break. Although progression to retinal detachment is not common, regular follow-up examinations are recommended.

Keywords

Retina Tear Retinopexy Laser retinopexy Retinal detachment 

Notes

Funding

The NIH provided financial support in the form of a core grant and the Research to Prevent Blindness, New York, NY, provided financial support in the form of an unrestricted grant. The sponsors had no role in the design or conduct of this research.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the University of Miami institutional review board and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of retrospective study, formal consent is not required.

References

  1. 1.
    Ghazi NG, Green WR (2002) Pathology and pathogenesis of retinal detachment. Eye 16(4):411–421CrossRefPubMedGoogle Scholar
  2. 2.
    Kanski JJ, Bowling B (2011) Clinical ophthalmology: a systematic approach. Elsevier, Edinburgh, pp 710–715Google Scholar
  3. 3.
    Davis MD (1974) Natural history of retinal breaks without detachment. Arch Opthalmol 92(3):183–194CrossRefGoogle Scholar
  4. 4.
    Kanski JJ, Daniel R (1975) Prophylaxis of retinal detachment. Am J Ophthalmol 79(2):179–205CrossRefGoogle Scholar
  5. 5.
    Smiddy WE, Flynn HW Jr, Nicholson DH et al (1991) Results and complications in treated retinal breaks. Am J Ophthalmol 112(6):623–631CrossRefPubMedGoogle Scholar
  6. 6.
    Levin M, Nasri A, Stewart JM (2009) Resident-performed prophylactic retinopexy and the risk of retinal detachment. Ophthalmic Surg Lasers Imaging 40(2):120–126CrossRefPubMedGoogle Scholar
  7. 7.
    Blindbaek S, Grauslund J (2015) Prophylactic treatment of retinal breaks—a systematic review. Acta Ophthalmol 93(1):3–8CrossRefPubMedGoogle Scholar
  8. 8.
    American Academy of Ophthalmology Retina/Vitreous Panel (2014) Preferred practice pattern guidelines. Posterior vitreous detachment, retinal breaks, and lattice degeneration. American Academy of Ophthalmology, San FranciscoGoogle Scholar
  9. 9.
    Ghosh YK, Banerjee S, Tyagi AK (2005) Effectiveness of emergency argon laser retinopexy performed by trainee doctors. Eye 19(1):52–54CrossRefPubMedGoogle Scholar
  10. 10.
    Mastropasqua L, Carpineto P, Ciancaglini M, Falconio G, Gallenga PE (1999) Treatment of retinal tears and lattice degenerations in fellow eyes in high risk patients suffering retinal detachment: a prospective study. Br J Ophthalmol 83(9):1046–1049CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Pollak A, Oliver M (1981) Argon laser photocoagulation of symptomatic flap tears and retinal breaks of fellow eyes. Br J Ophthalmol 65(7):469–472CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Shunmugan M, Shah AN, Hysi PG, Williamson TH (2014) The pattern and distribution of retinal breaks in eyes with rhegmatogenous retinal detachment. Am J Ophthalmol 157(1):221–226CrossRefGoogle Scholar
  13. 13.
    Khan AA, Gupta A, Bennet H (2013) Risk stratifying retinal breaks. Can J Ophthalmol 48(6):546–548CrossRefPubMedGoogle Scholar
  14. 14.
    Saran BR, Brucker AJ (1995) Macular epiretinal membrane formation and treated retinal breaks. Am J Ophthalmol 120(4):480–485CrossRefPubMedGoogle Scholar
  15. 15.
    Mester U, Volker B, Kroll P, Berg P (1988) Complications of prophylactic argon laser treatment of retinal breaks and degenerations in 2000 eyes. Ophthalmic Surg 19(7):482–484PubMedGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Ophthalmology, Bascom Palmer Eye InstituteUniversity of MiamiMiamiUSA

Personalised recommendations