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Robert Garoon, Harry W Flynn; Laser retinopexy for retinal tears: clinical course and outcomes.. Invest. Ophthalmol. Vis. Sci. 2018;59(9):4236.
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© ARVO (1962-2015); The Authors (2016-present)
The purpose of this study is to report the rates and timing of retreatments, new break formation, and vitreoretinal surgical intervention after treatment of retinal breaks and to identify factors that may be associated with increased rates of additional interventions. We performed a retrospective, observational clinical study to review outcomes of laser retinopexy at a single institution.
We reviewed 594 consecutive eyes with a retinal break that underwent laser retinopexy for prophylaxis of retinal detachment at the Bascom Palmer Eye Institute from 2013 through 2016. A total of 193 eyes were excluded due to lack of follow up, prior laser or vitreoretinal surgical intervention, or a lack of data leaving a cohort of 401 eyes for the current study. The main outcome measure was if additional laser or vitreoretinal surgery was performed after the initial laser retinopexy. Comparison between outcomes of residents and attending physicians were also performed.
Additional laser retinopexy after initial laser retinopexy was performed in 75 (18.7%) study eyes. Of 113 total additional laser sessions performed, 58 (51.3%) laser sessions were to retreat the original tear while 55 (48.7%) were to treat a new tear. Vitreoretinal surgery for retinal detachment after the initial laser retinopexy was performed in 23 (5.7%) eyes. Risk factors associated with surgery after laser treatment were superotemporal location of break (OR = 3.62; 95% CI = (1.40, 9.38); p= 0.008), having vitreous hemorrhage (OR = 2.62; 95% CI = (1.18, 5.81); p= 0.017), and more than one break (OR = 2.60; 95% CI = (1.22, 5.57); p= 0.014). Of eyes treated by residents, 20 (35.1%) received additional laser retinopexy, whereas 55 (16.0%) eyes were retreated by attendings (p<0.001). Five (8.8%) eyes initially treated with laser by residents underwent vitreoretinal surgery compared to 24 (7.0%) eyes in the group treated by attending physicians (p= 0.45). The final visual outcomes of these groups were similar (20/26 vs. 20/25, p= 0.48).
Following the initial treatment of a retinal break, additional treatment of the original break or of a new break is often performed during the follow up course. As progression to retinal detachment is not uncommon, regular follow up examinations are recommended. No difference between final visual outcomes or surgical rates of eyes treated by residents and attendings existed in the current study.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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