Prognostic factors for laser photocoagulation of retinal detachments

Abstract

Demarcation laser photocoagulation (DLP) is a low-morbidity procedure that may stabilize selected macula-sparing rhegmatogenous retinal detachments (MSRRDs) by producing a barrier to prevent extension of subretinal fluid (SRF). This procedure may be an alternative to other surgical approaches in patients who are asymptomatic without visual field loss from MSRRD, in simple localized retinal detachments or in patients who are poor candidates for surgery. One factor that appears to be critical for long-term success of DLP for MSRRD is the correct placement of multiple rows of confluent barricading laser photocoagulation spots. Posterior segment features that are favorable for successful DLP include shallow retinal detachment with localized SRF and well-formed vitreous with lack of vitreous traction or proliferative vitreoretinopathy. Less favorable factors for DLP stabilization of MSRRDs include incomplete or insufficient laser spots, corrugated morphology or dome-shaped appearance, extension of SRF preventing adequate laser barrier posteriorly, vigorous exercise, and blunt ocular trauma. Neither the extent nor the location of the retinal detachment appears to be critical when selecting candidates for DLP.

Keywords::

• demarcation laser photocoagulation
• prognosis
• rhegmatogenous retinal detachment
• subretinal fluid

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.