Prophylactic laser photocoagulation for retinal breaks before laser in situ keratomileusis.
OBJECTIVE
To determine the efficacy and safety of prophylactic laser photocoagulation for retinal breaks in myopic patients undergoing laser in situ keratomileusis (LASIK).


METHODS
Between August 1998 and August 2002, a total of 1931 eyes in 1006 patients requesting LASIK received a fundus examination with indirect ophthalmoscopy before surgery. For analysis, patients were divided into two groups according to the presence or absence of retinal breaks. All patients with retinal breaks underwent prophylactic laser photocoagulation to seal the breaks, even though they were asymptomatic.


RESULTS
Patient age ranged from 18 to 68 years (30.8 +/- 7.4 yr). Mean preoperative spherical equivalent refraction was -7.55 +/- 3.72 D (range -1.87 to -34.50 D). Retinal breaks were identified and treated in 39 eyes (2.02%) of 32 patients (3.2%); 1892 eyes of 974 patients had no retinal breaks. No statistically significant difference was found in age (P=.87) or gender (P=.91) between the two groups. However, a significantly higher preoperative spherical equivalent refraction was noted in patients with retinal breaks (-9.41 +/- 4.15 D) compared with those without (-7.52 +/- 3.71 D) (P=.017). During a mean 19-month follow-up, none of the patients developed retinal detachment except for one in a patient without retinal breaks who sustained ocular trauma 19 months after LASIK. This patient was treated with scleral buckle and the retina was attached after surgery.


CONCLUSIONS
Retinal breaks were identified and treated by photocoagulation in 2% of 1931 eyes before LASIK for myopia.
Lin
Shih-Chin
SC
Department of Ophthalmology, National Cheng Kung University Hospital, Taiwan, ROC.
Tseng
Sung-Huei
SH
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D020731:Keratomileusis, Laser In Situ / Q000379:methods*; D017075:Laser Coagulation; D008297:Male; D008875:Middle Aged; D009216:Myopia / Q000150:complications* / Q000601:surgery*; D009887:Ophthalmoscopy; D012029:Refraction, Ocular; D012167:Retinal Perforations / Q000150:complications* / Q000601:surgery*; D012449:Safety; D016896:Treatment Outcome; D014792:Visual Acuity