Barrage laser photocoagulation for macula-sparing asymptomatic clinical rhegmatogenous retinal detachments.
OBJECTIVE
To evaluate the efficacy of barrage laser photocoagulation in containing macula-sparing asymptomatic clinical retinal detachments (RD).


METHODS
Consecutive patients presenting with asymptomatic clinical RD were prospectively treated with barrage photocoagulation in 2-3 confluent rows, using frequency-doubled Nd:YAG (532 nm) laser on an indirect-ophthalmoscopic delivery system. The patients were reviewed at 0.5, 1.5, 3, and 6 months, and yearly thereafter. Best-corrected visual acuity (BCVA), and stability/progression of rhegmatous retinal detachment beyond the barrage were noted at each visit.


RESULTS
Nineteen phakic eyes of 17 patients (nine female patients), aged 12-58 years (average: 26 years), underwent barrage laser treatment. Two women had bilateral RD. Most detachments were caused by atrophic holes, and involved at least a quadrant of retina. Seven (37%) extended superiorly with breaks above the horizontal raphe. Three eyes had partial demarcation lines, and five had posterior vitreous detachment at presentation. The minimum follow-up was 6 months (mean: 21 months; range: 6-108 months). Pretreatment anatomical and functional status was maintained in 18 (95%) eyes till the final visit. One superotemporal RD progressed across the laser barrier into macula 5 months after photocoagulation, and BCVA dropped to 6/18. Scleral buckling was performed successfully, with visual recovery to 6/6.


CONCLUSIONS
Barrage photocoagulation may have a place in management of asymptomatic clinical detachments, as an effective and less morbid alternative to scleral buckling.
Aravind Eye Hospital & Postgraduate Institute of Ophthalmology, Madurai, Tamil Nadu, India. daksh@aravind.org
D
D
Shukla
R
R
Maheshwari
R
R
Kim
D000293:Adolescent; D000328:Adult; D002648:Child; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D017075:Laser Coagulation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012163:Retinal Detachment / Q000503:physiopathology / Q000601:surgery*; D012591:Scleral Buckling; D016896:Treatment Outcome; D014792:Visual Acuity