360-degree intra-operative laser retinopexy for the prevention of retinal re-detachment in patients treated with primary pars plana vitrectomy.

Abstract

To investigate the effect of 360° intra-operative laser retinopexy (ILR) for the prevention of retinal re-detachment in patients treated with pars plana vitrectomy (PPV) for primary rhegmatogenous retinal detachment (RRD). A retrospective single-institution cohort study was performed. Consecutive patients with primary uncomplicated RRD who underwent 23-gauge PPV with gas endotamponade between July 2013 and July 2016 were included in the study (n = 151). Two cohorts were compared: one which received laser retinopexy only around identified tears/holes/lattice zones (Control group, n = 86), and one which received additional 360° intra-operative laser retinopexy (360° ILR group, n = 65). Retinal re-detachment was seen in 4/65 eyes (6%) in the 360° ILR group compared to 18/86 eyes (21%) in the control group. In multiple logistic regression, the 360° ILR was associated with a 75% reduction in the odds of retinal re-detachment compared to control (OR = 0.248, 95% CI [0.079-0.772], p = 0.016). There was no statistically significant difference in the incidence of epiretinal membrane formation between the two groups. Intra-operative 360° laser retinopexy during PPV with gas endotamponade resulted in a significant reduction in the odds of postoperative retinal re-detachment in eyes with uncomplicated primary RRD.