Demarcation laser photocoagulation of selected macula-sparing rhegmatogenous retinal detachments.
OBJECTIVE
To report a series of macula-sparing rhegmatogenous retinal detachments (MSRRDs) treated with demarcation laser photocoagulation (DLP).


METHODS
Retrospective, noncomparative case series.


METHODS
Thirty-one patients (34 eyes) with primary or recurrent MSRRDs without associated visual field loss, necrotizing retinitis, or proliferative vitreoretinopathy (PVR), managed with DLP from November 1992 through May 1999.


METHODS
Demarcation laser photocoagulation consisting of a triple row of confluent laser burns.


METHODS
Best corrected postoperative visual acuity and MSRRD progression or recurrence.


RESULTS
Thirty-four primary and recurrent MSRRDs were treated by DLP, which consisted of a triple row of confluent laser burns. Macula-sparing rhegmatogenous retinal detachments were located in all quadrants and affected 10% to 45% of the retina. Findings associated with MSRRDs included lattice degeneration (12 eyes), vitreous hemorrhage (4 eyes), and demarcation line (9 eyes). Symptoms (photopsias or floaters) were associated with 14 MSRRDs. Eight eyes were myopic and 11 were pseudophakic. Thirty-two MSRRDs were shallow, two were dome shaped, and all were smooth without corrugations. Follow-up ranged from 1.5 to 80 months (mean, 15.8 months; median, 17 months). Thirty-three of 34 detachments remained stable after DLP. Three flattened spontaneously. One eye was managed with scleral buckle 6 weeks after DLP. Progression was attributed to incomplete laser treatment. Best corrected postoperative visual acuity was the same or improved in all but one eye, in which a cataract developed.


CONCLUSIONS
Demarcation laser photocoagulation is an effective method to manage acute or chronic, primary or recurrent MSRRDs without associated PVR that are shallow and smooth without corrugations. Demarcation laser photocoagulation is an alternative to both observation and surgical repair for these select MSRRDs.
Vrabec
T R
TR
Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania, USA. TRVRDMD@aol.com
Baumal
C R
CR
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D005260:Female; D006801:Humans; D017075:Laser Coagulation / Q000379:methods*; D008266:Macula Lutea / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012163:Retinal Detachment / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D012189:Retrospective Studies; D012591:Scleral Buckling; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology