RESEARCH ARTICLE


Prophylactic Circumferential Laser Retinopexy in Macular Hole and Epiretinal Membrane Surgeries



Oded Ohana1, *, #, Ran Rutenberg1, #, Elad Moisseiev2, Zvi Davidovich3, Anat Lowenstein1, Shulamit Schwartz1, Adiel Barak1
1 Department of Ophthalmology, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
2 Department of Ophthalmology, Meir Medical Center, Kfar-Saba, Israel
3 Schneider Children's Medical Center in Israel, Petach-Tikvah, Israel


© 2020 Ohana et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: (https://creativecommons.org/licenses/by/4.0/legalcode). This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Department of Ophthalmology, Tel Aviv Medical Center, 6 Weizmann St., Tel-Aviv 64236, Israel.
Tel: +972-3-6973408, Fax: +972-3-6973870, E-mail: odedoh@hotmail.com
# Equal contribution


Abstract

Background:

The role of PCLR in vitrectomy surgeries for macular diseases is controversial. Several studies report a reduction in post-operative RD rates, while other studies do not show such reduction. reducing complications stemming from intra- and post- operative retinal tears, especially at sclerotomy sites, are suggested as reasons for PCLR use.

Objective:

To investigate the effect of PCLR on the rate of post-operative RD in patients undergoing pars plana vitrectomy for either Macular Hole (MH) or epiretinal membrane (ERM).

Methods:

This retrospective study included 179 eyes of 170 patients who underwent vitrectomy for either MH or ERM between 2006-2012. Recorded parameters included demographic information, diagnosis, lens status, use and type of tamponade, whether PCLR was performed, follow-up period, the occurrence of RD, the cause and time of RD. Outcome and complication rates were compared between patients who received PCLR (PCLR group) and those who did not (Control group).

Results:

The study included 179 eyes of 170 patients. 126 eyes had PCLR while 53 eyes did not. Pre-operative demographics data, best-corrected visual acuity, lens status and indication for macular surgery were similar between the two groups. Post-operative RD was diagnosed in one eye (1.8%) in the control group and 5 eyes (3.9%) in the PCLR group (Kaplan-Meier survival analysis, log-rank p = 0.28).

Conclusion:

PCLR was not correlated with a decrease in RD in MH and ERM surgeries in our cohort. Intra-operative and post-operative examination for small retinal breaks is essential in all surgeries. PCLR might be unnecessary in small gauge vitrectomies.

Keywords: Circumferential laser barrage, Epiretinal membrane, Macular hole, Pars plana vitrectomy, Retinal detachment, Retinopexy, Prophylactic.