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Joey Luvisi, Aarsh Desai, Martin A Mainster, Radwan Ajlan; Endoscopy-assisted vitreoretinal surgery with an integrated or separate endolaser probe.. Invest. Ophthalmol. Vis. Sci. 2019;60(9):5788.
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© ARVO (1962-2015); The Authors (2016-present)
Endoscopy can provide effective visualization of intraocular locations difficult or impossible to view with an operating microscope. These areas can be photocoagulated during endoscopy-assisted vitreoretinal surgery using (1) an endolaser probe integrated into the endoscope or (2) a separate fiber optic probe that requires an additional sclerostomy wound. We compared clinical outcomes and complications for these alternative laser photocoagulation techniques.
We performed a retrospective cohort study on 55 patients who underwent endoscopy-assisted vitreoretinal surgery between August 2017 and June 2018 (17 females, 38 males; 55 eyes). Photocoagulation was performed using either (1) 810 nm diode infrared laser radiation delivered though a fiberoptic probe integrated into the endoscope (E2, Endo Optiks, Beaver-Visitec International) or (2) 532 nm frequency-doubled Nd:YAG green laser light transmitted through an independent endolaser probe (Constellation Vision System, Alcon, Novartis). Patients with an active retinal detachment were excluded. We documented patients’ age, gender, intraocular pressure (IOP), crystalline or artificial lens status, indication for surgery, clinical outcome, and adverse events. The study was approved by the Institutional Review Board of the University of Kansas School of Medicine.
Seventeen patients had 810 nm diode and 38 patients had 532 nm Nd:YAG laser endophotocoagulation. Mean age was 61.9±11.7 years for the diode laser group, and 62.6±13.9 years for the Nd:YAG laser group. Mean IOP on the first day after surgery was 12.9±7.2mmHg for the diode and 16±7.9mmHg for the Nd:YAG laser group. There was no significant difference between the two groups’ IOP measurements (p-value = 0.18). No patient in either group had intraoperative or postoperative choroidal effusion, suprachoroidal hemorrhage, retinal detachment or cataract formation acceleration.
Retinal photocoagulation during endoscopy-assisted vitreoretinal surgery can be performed effectively using either diode laser infrared radiation delivered through an endoscope-integrated probe or Nd:YAG laser green light transmitted through an independent endolaser probe. There was no difference in this study cohort between the complications or clinical outcomes of these two treatment modalities but a larger, longer-term prospective study is needed to confirm their clinical equivalence.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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