Prophylactic circumferential intraoperative laser retinopexy decreases the risk of retinal detachment after macular hole surgery.

PURPOSE

Pars plana vitrectomy with peeling of the internal limiting membrane is a well-established technique for the treatment of idiopathic macular holes with high success rates. Complications such as retinal tears may result from vitreous incarceration at the sclerotomy sites. Prophylactic laser retinopexy (LR) has recently been shown to decrease incidence of postvitrectomy rhegmatogenous retinal detachment but its efficacy in macular hole repair has not been established. In this study we evaluated the safety and efficacy of prophylactic LR and compared the patients to a control group that did not receive prophylactic treatment.

METHODS

A retrospective, consecutive chart review was conducted comparing patients who underwent macular hole repair with LR to without LR. Patient demographics were collected and the number and time interval of retinal detachment in the 2 groups were compared. Statistical analysis was conducted between the 2 groups.

RESULTS

A total of 144 eyes underwent macular hole repair during the study period. A total of 76 eyes underwent LR and 68 eyes did not undergo LR. There were no significant differences in baseline characteristics between the 2 groups. At 1 year, RD occurred in 1 eye (1.31%) in the LR group and in 8 eyes (8.82%) without LR group (p<0.01).

CONCLUSIONS

Prophylactic LR decreases the incidence of postoperative retinal detachment a potentially disabling complication of macular hole repair surgery.