title: The Incidence of Rhegmatogenous Retinal Complications in Macular Surgery After Prophylactic Preoperative Laser Retinopexy: A Retrospective Study.
abstract: The aim of the study is to evaluate the clinical characteristics of intraoperative retinal breaks (RBs) and postoperative retinal detachment (RRD) in patients undergoing pars plana vitrectomy (PPV) for macular disorders, who were treated preoperatively with prophylactic peripheral laser retinopexy.This observational cohort study comprised of 254 patients who underwent macular surgery and were preoperatively subjected to prophylactic laser retinopexy anterior to the equator. The main outcome measures were the incidence and characteristics of intraoperative RBs and postoperative RRD.Intraoperative RBs occurred in 14 patients (5.5%). Ten patients presented a sclerotomy-related RB (3.9%) and 4 patients a nonsclerotomy-related RB (1.6%). Two patients showed postoperative RRD (0.7%). Neither of the 2 patients with postoperative RRD was macula-off at presentation: one of them was successfully operated on with scleral buckling and the other was managed by observation alone. A significantly increased risk for the intraoperative development of sclerotomy-related RB was found in 20-gauge PPV compared with 23/25-gauge PPV.Preoperative prophylactic peripheral laser retinopexy does not guarantee the prevention of intraopertaive RBs or postoperative RRD. However, it might prevent the involvement of the macula when RRD occurs postoperatively.
authors.affiliation: From the Ophthalmology Section of the Department of Medicine, Surgery and Neuroscience (GMT, PE, NR, DM, PM, EN, GE), University of Siena, Siena; Department of Medical Biotechnologies (GC), University of Siena, Siena; and G.B. Bietti Foundation (GR), IRCCS Rome, Italy.
authors.forename: Gian Marco
authors.initials: GM
authors.lastname: Tosi
authors.forename: Pierluigi
authors.initials: P
authors.lastname: Esposti
authors.forename: Napoleone
authors.initials: N
authors.lastname: Romeo
authors.forename: Davide
authors.initials: D
authors.lastname: Marigliani
authors.forename: Gabriele
authors.initials: G
authors.lastname: Cevenini
authors.forename: Patrizio
authors.initials: P
authors.lastname: Massimo
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Nuti
authors.forename: Giulia
authors.initials: G
authors.lastname: Esposti
authors.forename: Guido
authors.initials: G
authors.lastname: Ripandelli
mesh_terms: D000368:Aged; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015994:Incidence; D007431:Intraoperative Complications / Q000453:epidemiology* / Q000209:etiology; D053685:Laser Therapy; D008268:Macular Degeneration / Q000601:surgery; D008297:Male; D013508:Ophthalmologic Surgical Procedures / Q000379:methods; D012160:Retina / Q000601:surgery*; D012163:Retinal Detachment / Q000453:epidemiology* / Q000209:etiology; D012167:Retinal Perforations / Q000453:epidemiology* / Q000209:etiology; D012189:Retrospective Studies; D014821:Vitrectomy / Q000009:adverse effects*