Failure of prophylactic retinopexy in fellow eyes without a posterior vitreous detachment.
OBJECTIVE
To describe adverse sequelae of retinal prophylaxis in fellow eyes of patients with rhegmatogenous retinal detachment.


METHODS
Records were reviewed for 17 patients who had retinal breaks or detachment subsequent to prophylactic retinopexy applied to the fellow eye (without posterior vitreous detachment) at the time of primary rhegmatogenous retinal detachment surgery. Subsequent treatment included cryotherapeutic and laser retinopexy, scleral buckling, and vitrectomy.


RESULTS
Of the 17 patients, 12 were male (mean age, 49 years). Laser retinopexy alone was used in 6 cases. Sixteen (94%) developed retinal tears related to acute posterior vitreous detachment, of which 8 (47%) were at the edge of retinopexy and 8 (47%) were in the normal or untreated retina. Thirteen (76%) developed a retinal detachment, of which 11 (85%) did not involve the fovea. Median visual acuity following treatment was 0.18 logMAR (6/9 Snellen equivalent).


CONCLUSIONS
Prophylactic retinopexy in fellow eyes without posterior detachment is not completely successful and may cause breaks to develop at the edge of treated areas during subsequent acute posterior vitreous detachment. Patient education alone regarding the symptoms of retinal tear and detachment may be preferable to prophylactic retinopexy of the fellow eye in the absence of a posterior vitreous detachment.
Chauhan
Devinder S
DS
Moorfields Eye Hospital, 162 City Road, London EC1V 2PD, England. devinderchauhan@hotmail.com
Downie
John A
JA
Eckstein
Michael
M
Aylward
G W
GW
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D007839:Functional Laterality; D006801:Humans; D017075:Laser Coagulation; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D012163:Retinal Detachment / Q000209:etiology* / Q000601:surgery*; D012167:Retinal Perforations / Q000209:etiology; D012591:Scleral Buckling; D017211:Treatment Failure; D014792:Visual Acuity; D014821:Vitrectomy; D020255:Vitreous Detachment