Transscleral retinopexy using a continuous wave Nd:YAG laser.
OBJECTIVE
Intraoperative retinopexy currently is performed transsclerally during surgery for retinal detachment by means of cryocoagulation, which usually results in much damage to the tissue. In this study, we investigated the potency of transscleral chorioretinal laser photocoagulation in achieving retinopexy with less breakdown of the blood-retina barrier and resulting in decreased protein leakage and reduced dispersion of the retinal pigment epithelium.


METHODS
A continuous wave (CW) Nd:YAG laser with a custom-made optical tip was used. The tip consists of an optical fiber protected by a steel casing for indentation of the sclera. Eight patients underwent the procedure.


RESULTS
Three to six pulses of 5.2-6.6 W and exposure duration of 300-500 mesec per spot were used to obtain mild to moderate photocoagulation; no retinal complications were observed. An average of 45 coagulations were obtained per patient. One patient showed mild scleral thermal effects. All retinas were attached after surgery, and seven remained attached at the 6-month follow-up examination.


CONCLUSIONS
Transscleral chorioretinal irradiation with the CW Nd:YAG laser is a suitable method for performing retinopexy. Because no thermal damage to the sclera occurred, this method seems to be a safe and effective procedure.
Fankhauser
F
F
St. Thomas' Hospital, United Medical School, Department of Ophthalmology, London, United Kingdom.
Messmer
E
E
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D017075:Laser Coagulation / Q000379:methods; D008297:Male; D008875:Middle Aged; D012160:Retina / Q000601:surgery*; D012163:Retinal Detachment / Q000601:surgery*; D012449:Safety; D012590:Sclera; D014792:Visual Acuity