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L. Q. Silveira, A. F. Bordon, G. Z. Ramos, V. Afonso, A. Raskin, M. Harasawa, G. Pelegrini, C. Moreira; Efficacy of Prophylactic 360º Laser Photocoagulation During Pars Plana Vitrectomy to Remove Retained Lens Fragments or Nucleus. Invest. Ophthalmol. Vis. Sci. 2010;51(13):6061.
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To compare the incidence of retinal detachment in patients submitted to pars plana vitrectomy to remove retained lens fragments or dropped nucleus between two groups: group that received prophylactic 360° laser photocoagulation and the group in which no laser was applied.
Retrospective, nonrandomized, consecutive, comparative, interventional study. Inclusion criteria: nucleus or lens fragments resulting from cataract surgery. Main exclusion criteria: previous panretinal laser photocoagulation, previous retinal surgery or ocular trauma. Patients were submitted to conventional 3-port pars plana vitrectomy with extensive removal of the vitreous base. One group (laser group) received 360º peripheral photocoagulation and the other did not (standard group).
thirty seven patients were identified and among those twenty one (21 eyes) met the inclusion criteria. Seven eyes had extracapsular cataract extraction (ECCE) and 14 had phacoemulsification (PHACO). Twelve eyes were in the laser group (4 ECCE and 8 PHACO) and 9 in the standard group (3 ECCE and 6 PHACO). Statistical analysis showed no difference (p=0,486). Two eyes in the laser group and none in the standard group had retinal detachment. The RD occurred 36 and 87 days after the PPV. Age of patients, axial length of the eye, time between cataract extraction and pars plana vitrectomy and size of the dropped nucleus (fragments or entire) between the two groups were not statistically significant.
Prophylactic 360° laser photocoagulation in the retinal periphery during pars plana vitrectomy to remove retained lens fragments or nucleus was not effective in preventing retinal detachment. However, further studies with more patients must be performed in order to identify other risk factors for RD in such patients.
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