Comparison of treatment outcomes of 360° intraoperative laser retinopexy and focal laser retinopexy with pars plans vitrectomy in patients with primary rhegmatogenous retinal detachment

BACKGROUND: This study was to compare the outcomes of 360° intra-operative laser retinopexy (ILR) and focal laser retinopexy in treating patients with pars plans vitrectomy (PPV) for primary rhegmatogenous retinal detachment (RRD). To identify other potential risk factors for retinal re-detachment after primary PPV.

METHODS: This was a retrospective cohort study. Three hundred and forty-four consecutive cases of primary rhegmatogenous retinal detachment treated with PPV were included between July 2013 and July 2018. Clinical characteristics and surgical outcomes were compared between focal laser retinopexy and additional 360° intra-operative laser retinopexy groups. Both univariate and multiple variable analysis were used to identify potential risk factors for retinal re-detachment.

RESULTS: Median follow-up was 6.2 months (Q1, Q3:2.0, 17.2). As estimated with survival analysis, the 360º ILR group had the incidence of 9.74% and focal laser 19.54% at 6 months postoperatively. At 12 months postoperatively the difference was 10.78% vs. 25.21%. The difference in survival rates was significant (p = 0.0021). In multivariate Cox regression, the risk factors for retinal re-detachment were without additional 360° ILR, diabetes and macula off before the primary surgery (relatively OR = 0.456, 95%-CI [0.245-0.848], p < 0.05; OR = 2.301, 95% CI [1.130-4.687], p < 0.05; OR = 2.243, 95% CI [1.212-4.149], p < 0.05).

CONCLUSION: Additional 360° ILR group had a significantly lower rate of retinal re-detachment when compared with focal laser retinopexy group. Our study also elucidated that diabetes and macular off before the primary surgery might also be the potential risk factors for higher rate of retinal re-detachment outcome.

TRIAL REGISTRATION: This was a retrospective cohort study.