Abstract
Purpose :
Retinal detachment (RD) is a sight threatening condition that typically requires surgical repair. During RD repair, endolaser photocoagulation is frequently used to treat retinal breaks. In patients undergoing complex RD repair, endoscopy-assisted pars plana vitrectomy (E-PPV) facilitates posterior segment visualization and may increase reattachment rates. However, treating retinal breaks using the endoscopy probe laser can be challenging due to endoscopic image movement. A separate endolaser probe can be used to overcome this issue. The purpose of this study is to report the outcomes of using a separate endolaser probe for photocoagulation during E-PPV in patients with complex RDs.
Methods :
A retrospective chart review of patients undergoing E-PPV for complex RD repair at a tertiary referral center from December 4th, 2017 to March 1st, 2021 was conducted. All included patients were adults who underwent E-PPV with separate endolaser probe photocoagulation for complex RDs. Patients’ demographics and clinical data (including visual acuity, reason for surgery, and surgical outcome) were collected and analyzed. The institutional review board approved this study.
Results :
A total of 37 patients (14 females and 23 males) underwent E-PPV for complex RD repair over the study period. The average age of patients was 52.3 and ranged from 23 to 92 years old. All patients (100%) underwent laser photocoagulation with a 532 nm endolaser probe during surgery. One patient (2.7%) had a rhegmatogenous RD with giant retinal tear while 36 patients (97.3%) had tractional RDs. Single surgery success rate was 91.9%. Three patients (8.1%) had recurrent macula on tractional RDs. Two of these three patients underwent subsquent successful surgical repair.
Conclusions :
Separate endolaser photocoagulation probe utilization during E-PPV for complex RD repair facilitated target retinal tissue treatment under endoscopic visualization. This approach eliminates endoscopic image movement associated with the endoscopy probe laser. In this study, E-PPV surgical success rate for complex RDs repair was comparable to reported surgical success rates in the literature. Larger prospective trials are needed to further clarify the value and practicality of this approach during E-PPV.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.