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July 1993

Pilot Trial of Transscleral Diode Laser Retinopexy in Retinal Detachment Surgery

Author Affiliations

From The Wilmer Ophthalmological Institute, Johns Hopkins Medical Institutions, Baltimore, Md (Drs Haller, Lim, and Goldberg). Dr Lim is now with the Department of Ophthalmology, Emory University Medical Center, Atlanta, Ga. The authors have no commercial or proprietary interest in IRIS Medical Instruments Inc, Mountain View, Calif.

Arch Ophthalmol. 1993;111(7):952-956. doi:10.1001/archopht.1993.01090070070022

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.