TRANSSCLERAL RETINOPEXY USING A CONTINUOUS-WAVE ND-YAG LASER

Purpose: Intraoperative retinopexy currently is performed transscleral ly during surgery for retinal detachment by means of cryocoagulation, which usually results in much damage to the tissue. In this study, we investigated the potency of transscleral chorioretinal laser photocoag ulation in achieving retinopexy with less breakdown of the blood-retin a barrier and resulting in decreased protein leakage and reduced dispe rsion of the retinal pigment epithelium. Methods: A continuous wave (C W) Nd:YAG laser with a custom-made optical tip was used. The tip consi sts of an optical fiber protected by a steel casing for indentation of the sclera. Eight patients underwent the procedure. Results: Three to six pulses of 5.2-6.8 W and exposure durations of 300-500 msec per sp ot were used to obtain mild to moderate photocoagulation; no retinal c omplications were observed. An average of 45 coagulations were obtaine d per patient. One patient showed mild scleral thermal effects. All re tinas were attached after surgery, and seven remained attached at the 6-month follow-up examination. Conclusion: Transscleral chorioretinal irradiation with the CW Nd:YAG laser is a suitable method for performi ng retinopexy. Because no thermal damage to the sclera occurred, this method seems to be a safe and effective procedure.