Clinical Study
Eye (2007) 21, 742–745; doi:10.1038/sj.eye.6702318; published online 17 March 2006
Barrage laser photocoagulation for macula-sparing asymptomatic clinical rhegmatogenous retinal detachments
D Shukla1, R Maheshwari1 and R Kim1
1Aravind Eye Hospital & Postgraduate Institute of Ophthalmology, Madurai, Tamil Nadu, India
Correspondence: D Shukla, Retina-Vitreous Service, Aravind Eye Hospital & Postgraduate Institute of Ophthalmology, 1 Anna Nagar, Madurai 625 020, Tamil Nadu, India. Tel: +91 452 4356100; Fax: +91 452 2530984; E-mail: daksh@aravind.org, daksh66@rediffmail.com
Received 22 November 2005; Accepted 29 January 2006; Published online 17 March 2006.
Abstract
Purpose
To evaluate the efficacy of barrage laser photocoagulation in containing macula-sparing asymptomatic clinical retinal detachments (RD).
Methods
Consecutive patients presenting with asymptomatic clinical RD were prospectively treated with barrage photocoagulation in 2–3 confluent rows, using frequency-doubled Nd:YAG (532 nm) laser on an indirect-ophthalmoscopic delivery system. The patients were reviewed at 0.5, 1.5, 3, and 6 months, and yearly thereafter. Best-corrected visual acuity (BCVA), and stability/progression of rhegmatous retinal detachment beyond the barrage were noted at each visit.
Results
Nineteen phakic eyes of 17 patients (nine female patients), aged 12–58 years (average: 26 years), underwent barrage laser treatment. Two women had bilateral RD. Most detachments were caused by atrophic holes, and involved at least a quadrant of retina. Seven (37%) extended superiorly with breaks above the horizontal raphe. Three eyes had partial demarcation lines, and five had posterior vitreous detachment at presentation. The minimum follow-up was 6 months (mean: 21 months; range: 6–108 months). Pretreatment anatomical and functional status was maintained in 18 (95%) eyes till the final visit. One superotemporal RD progressed across the laser barrier into macula 5 months after photocoagulation, and BCVA dropped to 6/18. Scleral buckling was performed successfully, with visual recovery to 6/6.
Conclusions
Barrage photocoagulation may have a place in management of asymptomatic clinical detachments, as an effective and less morbid alternative to scleral buckling.
Keywords:
barrage, photocoagulation, retinal detachment, demarcation, prophylaxis
