Management of the fellow eyes of patients with rhegmatogenous retinal detachment.

The experience of the senior author over the past 18 years in the management of fellow eyes of 3,036 patients with rhegmatogenous detachment is reported. The study group is composed of 2,221 patients with no history of detachment surgery or prophylactic treatment in the functional fellow eye. Of 816 eyes with retinal breaks, lattice degeneration, or retinoschisis-the types of pathology most conducive to detachment-70% were treated with xenon-arc photocoagulation or cryoapplication. Detachment occurred subsequently in 5.4% of the eyes treated with photocoagulation, 2% of the eyes treated with cryoapplications, and 8.2% of the eyes with major pathology that were not treated. Essentially normal fellow eyes with no major pathology and, consequently no treatment, had a subsequent detachment rate of 5.3%. The authors conclude that prophylactic treatment via transconjunctival cryoapplication is safe and effective and recommend treatment of all fellow eyes with lattice degeneration and breaks.