The Effect of Prophylactic 360-degree Barrier Laser Photocoagulation during Vitrectomy for Dropped Lens Fragments

Abstract

Purpose: To evaluate the effect of prophylactic 360-degree barrier laser photocoagulation (BLP) for prevention of retinal detachment during pars plana vitrectomy (PPV) for dropped lens fragments during cataract surgery. Methods: This retrospective analysis divided 94 eyes of 94 patients who underwent PPV for dropped lens fragments during cataract surgery between January 2014 and December 2019, into 360° BLP and control groups. The baseline characteristics and the risk of postoperative retinal detachment were analyzed and compared between the groups. Results: During PPV, the treatment group of 360° BLP comprised 62 eyes of 62 patients, and the control group without laser treatment was 32 eyes of 32 patients. At 12 months after PPV, the 360° BLP group showed significant reduction (0%, 0/62 eyes) in the incidence of retinal detachment after vitrectomy compared with the control group (9.3%, 3/32 eyes) (p = 0.037). Retinal detachment after PPV was related with severe corneal edema (p = 0.007) or no performance of 360° BLP (p = 0.025). In the order of importance, factors affecting retinal detachment were corneal edema (β = -0.470) and 360° BLP (β = -0.300). Conclusions: Prophylactic 360° BLP during PPV for dropped lens fragments in the vitreous during cataract surgery significantly reduced the incidence of retinal detachment after surgery, and this preventive laser treatment is expected to be useful, especially if corneal edema is severe before surgery.