D Shukla1, R Maheshwari, R Kim. 1. Aravind Eye Hospital & Postgraduate Institute of Ophthalmology, Madurai, Tamil Nadu, India. daksh@aravind.org
Abstract
PURPOSE: To evaluate the efficacy of barrage laser photocoagulation in containing macula-sparing asymptomatic clinical retinal detachments (RD). METHODS: Consecutive patients presenting with asymptomatic clinical RD were prospectively treated with barrage photocoagulation in 2-3 confluent rows, using frequency-doubled Nd:YAG (532 nm) laser on an indirect-ophthalmoscopic delivery system. The patients were reviewed at 0.5, 1.5, 3, and 6 months, and yearly thereafter. Best-corrected visual acuity (BCVA), and stability/progression of rhegmatous retinal detachment beyond the barrage were noted at each visit. RESULTS: Nineteen phakic eyes of 17 patients (nine female patients), aged 12-58 years (average: 26 years), underwent barrage laser treatment. Two women had bilateral RD. Most detachments were caused by atrophic holes, and involved at least a quadrant of retina. Seven (37%) extended superiorly with breaks above the horizontal raphe. Three eyes had partial demarcation lines, and five had posterior vitreous detachment at presentation. The minimum follow-up was 6 months (mean: 21 months; range: 6-108 months). Pretreatment anatomical and functional status was maintained in 18 (95%) eyes till the final visit. One superotemporal RD progressed across the laser barrier into macula 5 months after photocoagulation, and BCVA dropped to 6/18. Scleral buckling was performed successfully, with visual recovery to 6/6. CONCLUSIONS: Barrage photocoagulation may have a place in management of asymptomatic clinical detachments, as an effective and less morbid alternative to scleral buckling.
PURPOSE: To evaluate the efficacy of barrage laser photocoagulation in containing macula-sparing asymptomatic clinical retinal detachments (RD). METHODS: Consecutive patients presenting with asymptomatic clinical RD were prospectively treated with barrage photocoagulation in 2-3 confluent rows, using frequency-doubled Nd:YAG (532 nm) laser on an indirect-ophthalmoscopic delivery system. The patients were reviewed at 0.5, 1.5, 3, and 6 months, and yearly thereafter. Best-corrected visual acuity (BCVA), and stability/progression of rhegmatous retinal detachment beyond the barrage were noted at each visit. RESULTS: Nineteen phakic eyes of 17 patients (nine female patients), aged 12-58 years (average: 26 years), underwent barrage laser treatment. Two women had bilateral RD. Most detachments were caused by atrophic holes, and involved at least a quadrant of retina. Seven (37%) extended superiorly with breaks above the horizontal raphe. Three eyes had partial demarcation lines, and five had posterior vitreous detachment at presentation. The minimum follow-up was 6 months (mean: 21 months; range: 6-108 months). Pretreatment anatomical and functional status was maintained in 18 (95%) eyes till the final visit. One superotemporal RD progressed across the laser barrier into macula 5 months after photocoagulation, and BCVA dropped to 6/18. Scleral buckling was performed successfully, with visual recovery to 6/6. CONCLUSIONS: Barrage photocoagulation may have a place in management of asymptomatic clinical detachments, as an effective and less morbid alternative to scleral buckling.
Authors: Bhim B Rai; Michael G Morley; Pema Zangmo; Thukten Tshering; Abi N Khatiwara; Paul S Bernstein; Ted Maddess Journal: BMC Ophthalmol Date: 2020-10-08 Impact factor: 2.209