June 2013
Volume 54, Issue 15
Free
ARVO Annual Meeting Abstract  |   June 2013
Complete prevention of retinal detachment using prophylactic intraoperative septated circumferential barrier laser during macular surgery: long-term follow-up results
Author Affiliations & Notes
  • June-Gone Kim
    Ophthalmology, Asan Medical Center, Seoul, Republic of Korea
  • Hyun Seung Yang
    Ophthalmology, Asan Medical Center, Seoul, Republic of Korea
Investigative Ophthalmology & Visual Science June 2013, Vol.54, 2853. doi:
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      June-Gone Kim, Hyun Seung Yang; Complete prevention of retinal detachment using prophylactic intraoperative septated circumferential barrier laser during macular surgery: long-term follow-up results. Invest. Ophthalmol. Vis. Sci. 2013;54(15):2853.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract
 
Purpose
 

To investigate the efficacy and safety of using a prophylactic intraoperative septated circumferential barrier laser (SCBL) to prevent retinal detachment (RD) after complete phacovitrectomy.

 
Methods
 

Four hundred and seventy-eight consecutive patients who underwent a phacovitrectomy between 2004 and 2011 to treat cataract combined epiretinal membrane (ERM) and macular hole (MH) using 20G, 23G and 25G conventional vitrectomy system were analyzed retrospectively. Patients who were under 50 years old and had a history of severe diabetic retinopathy, glaucoma, high myopia, severe ocular disease, uveitis, previous laser treatment, any kind of intraocular injection and a posterior capsular tear during the surgery excluded. Three hundred and four patients received SCBL (group 1) and 174 patients did not (group2). In the SCBL procedure, one or two rows of circumferential moderate intensity burns were placed anteriorly to the equator with a subsequent 5-6 septate laser burns made from the circumferential laser marks to the anterior vitreous base perpendicularly at intervals of about 60 degrees (Fig. 1).

 
Results
 

The average age was 69.9 years and the minimum follow-up period was 12 months (average: 35.9 months). The average axial length and spherical equivalent were 23.9 mm and -0.45D, respectively. The SCBL procedure required an additional 213±21.2 seconds. SCBL was associated with a significant reduction of RD (from 1.7% in group 2 to 0% in group 1; P=0.048). Postoperative complications related to SCBL such as anatomical failure in MH, macular edema and ERM were not significantly different between the two groups (P=0.67, P=0.83, and P=0.81, respectively) at 1 year follow up.

 
Conclusions
 

Prophylactic intraoperative SCBL produces a significant benefit by preventing postoperative RD without any significant complications in ERM and MH surgery.

 
 
Fig. 1. Schematic representation of intraoperative prophylactic septated circumferential barrier laser (SCBL) and three sclerotomy sites
 
Fig. 1. Schematic representation of intraoperative prophylactic septated circumferential barrier laser (SCBL) and three sclerotomy sites
 
Keywords: 697 retinal detachment • 762 vitreoretinal surgery • 578 laser  
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