Postoperative laser coagulation as retinopexy in patients with rhegmatogenous retinal detachment treated with scleral buckling surgery: a prospective clinical study

PURPOSE: To evaluate postoperative laser photocoagulation as retinopexy mode in patients with rhegmatogenous retinal detachment treated with scleral buckling surgery.

METHODS: The authors conducted a prospective feasibility study of consecutive patients with rhegmatogenous retinal detachment treated with scleral buckling surgery and postoperative laser during an 18-month period with a minimal follow-up of 6 months. Outcome measures were total retinal reattachment and the occurrence of proliferative vitreoretinopathy (PVR).

RESULTS: A total of 123 patients (124 eyes) were included in this study. Seventy-six percent were phakic and 24% were pseudophakic. Fifty percent presented with one horseshoe tear, 15% with multiple tears, 30% with round breaks, and 5% with no identifiable break. Ten percent presented with a vitreous hemorrhage and 25% with three or four quadrants of detached retina. Six patients had PVR C1. Twelve patients required a postoperative gas injection, five patients received an additional buckle, and five patients underwent a vitrectomy, in four because of PVR. In all patients the retina was fully reattached at the end of follow-up. Planned postoperative laser coagulation took place 1 day to 10 weeks (median 3(1/2) weeks) after buckling surgery. Buckling material was removed in three patients without redetachment.

CONCLUSION: Postoperative laser coagulation is a feasible alternative retinopexy mode in scleral buckling surgery, with encouraging anatomical results and a low incidence of PVR.