Long Term Results of Prophylactic Laser For Fundal Coloboma

Abstract

Purpose: The role of prophylactic laser in fundal coloboma (FC) to prevent development of retinal detachment(RD) is controversial. The authors aim is to describe the long term results of such procedure.

Methods: Hospital records of FC cases, following up at Retina clinic of an Indian tertiary eye care centre were analyzed. All FC cases had received three to four rows of contiguous laser spots at coloboma margin including the anterior margin, and sparing the macula.

Results: 407 eyes of 260 patients were analyzed. Mean age (± SD) was 20.9 (± 13.2) years, ranging from 5-62 years. 28 patients (10.7%) had unilateral FC. Follow up period ranged from 1-17 years, mean (±SD) being 5.1 (±3.8) years. According to Ida Mann’s classification, 163 eyes (40%) had type 1, 153 eyes had type 2 (38%), 77 eyes had type 3 (19%), and 14 eyes (3%) had type 5 coloboma. Only 2 eyes (0.5%) developed RD (one with type 5 and another with type 2 coloboma) which underwent successful vitreoretinal surgery. There was no significant difference (p=0.4) in mean pre-laser best corrected visual acuity (BCVA) (LogMAR 1.23 ± 0.57) and mean BCVA at final follow up (LogMAR 1.24 ± 0.57).

Conclusions: Prophylactic laser of FC has shown encouraging results in preventing RD in our clinical practice. It can help to maintain BCVA in these cases in long term. We recommend prophylactic laser to all FC cases presenting after 4 years of age.