Abstract Objective: To evaluate the safety and efficacy of the transscleral diode laser for retinopexy in rhegmatogenous retinal detachments. Design: Ten consecutive patients with primary rhegmatogenous retinal detachments underwent scleral buckling surgery, using the transscleral diode laser for retinopexy. Patients were followed up for at least 6 months. Study Participants: Ten patients with primary rhegmatogenous retinal detachments were enrolled. Patients with chronic detachments, a retinal break greater than 90°, history of uveitis or infectious retinopathy, or proliferative vitreoretinopathy were excluded. Main Outcome Measure: Retinal reattachment. Secondary measures: visual acuity and complications, including choroidal, retinal, and vitreous hemorrhage, inflammation, and scleral damage. Results: By 6 months, nine of 10 retinas were successfully repaired following only one operation. The retina of the 10th patient redetached at 6½ weeks owing to proliferative vitreoretinopathy. Following a vitrectomy and retinal reattachment procedure, the retina of the 10th patient has remained attached for 1 year. No significant complications were encountered with the laser retinopexy, although small presumed breaks in Bruch's membrane occurred in three eyes and a moderate scleral thermal effect occurred in two. Visual results in the postoperative course were comparable to those achieved previously with cryotherapy. Conclusion: In this pilot series, transscleral diode laser retinopexy served as a safe and effective means of obtaining chorioretinal adhesion in retinal detachment surgery. References 1. Lincoff HA, McLean JM, Nano H. Cryosurgical treatment of retinal detachment . Trans Am Acad Ophthalmol Otolaryngol . 1964;68:412-432. 2. Norton EWD. Present status of cryotherapy in retinal detachment surgery . Trans Am Acad Ophthalmol Otolaryngol . 1969;73:1029-1034. 3. Schepens CL. Retinal Detachment and Allied Diseases . Philadelphia, Pa: WB Saunders Co; 1983. 4. Schwartz A, Rathbun E. Scleral strength impairment and recovery after diathermy . Arch Ophthalmol . 1975;93:1173-1177.Crossref 5. Welch RB. A survey of retinal detachment surgeons on the use of cryotherapy or diathermy . Am J Ophthalmol . 1970;69:749-754. 6. Meredith TA, Reeser FH, Topping TM, Aaberg TM. Cystoid macular edema after retinal detachment surgery . Ophthalmology . 1990;87:1090-1095.Crossref 7. Ackerman AL, Topilow HW. A reduced incidence of cystoid macular edema following retinal detachment surgery using diathermy . Ophthalmology . 1985;92:1092-1095.Crossref 8. Campochiaro PA, Kaden IH, Vidaurri-Leal J, Glaser BM. Cryotherapy enhances intravitreal dispersion of viable retinal pigment epithelial cells . Arch Ophthalmol . 1985;103:434-436.Crossref 9. Jaccoma EH, Conway BP, Campochiaro PA. Cryotherapy causes extensive breakdown of the blood-retinal barrier: a comparison with argon laser photocoagulation . Arch Ophthalmol . 1985;103:1728-1730.Crossref 10. Okamoto S, Takahasi H, Fukado Y, Ozawa T. Laser diode application of transscleral photocoagulation . Lasers Light Ophthalmol . 1990;3:29-37. 11. Jennings T, Fuller T, Vukich JA, et al. Transscleral contact retinal photocoagulation with an 810-nm semiconductor diode laser . Ophthalmic Surg . 1990;21:492-496. 12. Peyman GA, Naguib K, Gaasterland DE. Transscleral application of semiconductor diode laser . Lasers Surg Med . 1990;10:569-575.Crossref 13. Arrindell EL, Wu JC, Wolf MD, et al. MRI evaluation of blood-retinal barrier integrity following transconjunctival diode laser photocoagulation and retinal cryotherapy . Invest Ophthalmol Vis Sci . 1992;33( (suppl) ):1125. 14. Benner JD, Huang M, Ishigooka H, et al. Binocular indirect laser ophthalmoscope and diode transscleral laser photocoagulation in the rabbit . Invest Ophthalmol Vis Sci . 1991;32( (suppl) ):27-64. 15. Smiddy WE. Diode endolaser photocoagulation . Arch Ophthalmol . 1992;110:1172-1174.Crossref 16. Smiddy WE, Hernandez E. Histopathologic characteristics of diode laser-induced chorioretinal adhesions for experimental retinal detachment in rabbit eyes . Arch Ophthalmol . 1992;110:1630-1633.Crossref 17. Smiddy WE, Hernandez E. Histopathologic results of retinal diode laser photocoagulation in rabbit eyes . Arch Ophthalmol . 1992;110:693-698.Crossref 18. Rosen RB, Muldoon TO, Walsh JB, McCormick SA. A cryo-like, semiconductor diode laser probe for transscleral retinopexy: evaluation in a rabbit model . Invest Ophthalmol Vis Sci . 1992;33( (suppl) ):1311. 19. Kletzky DL, Cupples HD, Gaasterland DE. Transscleral retinal photocoagulation with the diode laser . Invest Ophthalmol Vis Sci . 1992;33( (suppl) ):1311. 20. Smith RS, Stein MN. Ocular hazards of transscleral laser radiation . Am J Ophthalmol . 1969;67:100-110. 21. Rol P, Niederer P, Durr U, Henchoz PD, Fankhauser F. Experimental investigations on the light scattering properties of the human sclera . Lasers Light Ophthalmol . 1990;3:201-212. 22. Vogel A, Dlugos C, Nuffer R, Birngruber R. Optical properties of human sclera, and their consequences for transscleral laser applications . Lasers Surg Med . 1990;11:331-340.Crossref 23. Sato Y, Berkowitz BA, Wilson CA, de Juan E Jr. Blood-retinal barrier breakdown caused by diode vs argon laser endophotocoagulation . Arch Ophthalmol . 1992;110:277-281.Crossref 24. Zauberman H. Tensile strength of chorioretinal lesions produced by photocoagulation, diathermy, and cryopexy . Br J Ophthalmol . 1969;53:749-752.Crossref 25. Geeraets WJ, Williams RC, Chan G, Ham WT Jr, Guerry D, Schmidt FH. The relative absorption of thermal energy in retina and choroid . Invest Ophthalmol Vis Sci . 1962;1:340-347.
Archives of Ophthalmology – American Medical Association
Published: Jul 1, 1993
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