Does demarcation laser photocoagulation really barricade the macula sparing symptomatic and asymptomatic clinical rhegmatogenous retinal detachment

Abstract

Purpose The aim of this study was to evaluate the efficacy of demarcation laser photocoagulation in containing macula-sparing symptomatic or asymptomatic clinical retinal detachments. Design This was a prospective interventional case series. Patients and methods Sixteen eyes of 14 consecutive patients presenting with symptomatic (14 eyes) and asymptomatic (two fellow eyes) clinical macula-sparing rhegmatogenous retinal detachments (MSRRDs) were prospectively treated with barrage photocoagulation in three to five confluent rows using argon laser photocoagulation with a slit lamp delivery system for 15 eyes and the indirect ophthalmoscopic delivery system in one eye. The patients were reviewed at 1, 7, and 15 days, 1, 3, and 6 months, and yearly thereafter. Stability/progression of rhegmatogenous retinal detachment beyond the barrage and the best corrected visual acuity were recorded at each visit. Results Sixteen eyes of 14 patients (nine male) with a mean±standard age of 42.93±16.65 years (range 12–62 years) underwent barrage laser treatment. Two men had bilateral retinal detachment. Most detachments were caused by horseshoe breaks (12 eyes) (75%). Eight (50%) extended superiorly with breaks above the horizontal raphe. Twelve eyes (75%) had posterior vitreous detachment at presentation. The patients are still under regular yearly follow-up. The pretreatment anatomical and functional status was maintained in all eyes until the final visit. Conclusion Demarcation laser photocoagulation is a low-morbidity procedure that can efficiently stabilize selected clinical MSRRDs by producing a barrier to prevent extension of the subretinal fluid. This procedure may be an alternative to other surgical approaches in patients with symptomatic or asymptomatic MSRRDs.