Abstract
Purpose :
Although vitrectomy is the most popular procedure for rhegmatogenous retinal detachment (RRD) with a high success rate, retinal detachment may recur still. As the vitreous base cannot be completely removed practically, 360-degree prophylactic layer was advocated by some researchers. However the prophylactic laser would be related to potential overtreatment, and the traction force to the retina would be concentrated to the posterior border of the vitreous base. Herein, we developed the novel procedure of barrier laser fortified on the vitreous base adjacent to the break, and its efficacy was investigated.
Methods :
The study was conducted as a retrospective review of medical record. Patients who underwent 3 ports pars plana vitrectomy using 25-G system for RRD without PVR were included. During vitrectomy, 3 - 4 rows of barrier laser was applied surrounding the break at the end of fluid-air exchange. For the fortified barrier laser, 3 - 4 rows of laser burn were made additionally about 0.5 clock-hour long adjacent to the break along the posterior border of the vitreous base. The vitreous was tamponaded with non-expansile gas. The primary outcome was single surgery success rate (SSSR) between two groups; fortified barrier laser (FBL) group and conventional barrier laser (CBL) group.
Results :
In total, 118 eyes were eligible for the inclusion; 50 were in FBL group and 68 eyes in CBL group. There were no significant differences in the baseline characteristics and surgical procedures except for the tamponade, for which air was used most frequently in FBL group and SF6 in CBL group. SSSR was 100% (50/50) in FBL group and 91.2% (62/68) in CBL group with a significant difference (p=0.038). Four eyes of the recurrent cases had no other breaks found in the second surgery, and the recurrence was related to reopening of the break in the primary operation. All eyes achieved reattachment finally, and no differences were found in postoperative visual acuity finally.
Conclusions :
FBL on the vitreous base was efficacious to improve anatomical success rate of vitrectomy by preventing recurrence related to reopening of the retinal break.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.