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Twelve-month analysis of emergency argon laser retinopexy in an Irish tertiary hospital

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Abstract

Background

Retinal tears occur as a result of traction at sites of retinal and vitreous adhesion—this allows retrohyaloid fluid into the subretinal space. Prompt management is required to prevent progression to rhegmatogenous retinal detachment (RRD).

Aims

To identify the post-procedural outcomes following treatment of retinal tears with laser retinopexy in an emergency setting.

Methods

Retrospective review of all patients who underwent emergency slit-lamp laser retinopexy between January and December 2021 in Cork University Hospital, an Irish tertiary referral centre.

Results

A total of 87 patients were identified—mean age of 60 ± 12 years and 54% female. Follow-up ranged from 1 week to 11 months. Pre-disposing risk factors were identified—myopia (37%), recent trauma (2%), and RRD family history (5%).

All patients had slit-lamp mounted laser-retinopexy performed in the eye-casualty. 63 patients (72%) had a superior break, 66 patients (76%) had a horse-shoe retinal tear, and 21 patients (24%) had a retinal hole. Associated findings included lattice degeneration (26%), sub-retinal fluid (55%), and vitreous haemorrhage (33%).

Fourteen patients (16%) required multiple slit-lamp laser retinopexies while 18 patients (21%) required intervention by a vitreo-retinal surgeon including indirect-laser retinopexy (3%), cryotherapy (11%), and pars-plana vitrectomy (6%). At the most recent follow-up, all the patients had anatomically attached retinas.

Conclusion

A notable proportion of patients (21%) undergoing emergency laser retinopexy required further intervention. Patients with anteriorly located retinal tears would benefit from an early discussion with a vitreo-retinal surgeon. Departmental training in laser retinopexy and retinal tear management is recommended as part of ongoing quality improvement.

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Authors and Affiliations

  1. Department of Ophthalmology, Cork University Hospital, Cork, Ireland

    Kealan McElhinney, Robert McGrath, Rory Holohan & Zubair Idrees

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  1. Kealan McElhinney
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Correspondence to Kealan McElhinney.

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This study was performed in compliance with the principles of the Declaration of Helsinki. The ethics committee-decided approval was not necessary for this study as it consisted of retrospective chart review with no additional patient contact or intervention. No patients are identifiable from the data presented.

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McElhinney, K., McGrath, R., Holohan, R. et al. Twelve-month analysis of emergency argon laser retinopexy in an Irish tertiary hospital. Ir J Med Sci (2023). https://doi.org/10.1007/s11845-023-03549-6

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