THE USE OF PANORAMIC VIEWING SYSTEM IN RELAXING RETINOTOMY AND RETINECTOMY

Background: Retinotomies and retinectomies are surgical procedures mai nly devoted to the peripheral retina that require optimal visibility a nd adequate magnification to make the surgeon's task easy, quick, and safe. The purpose of present study was to estimate to what extent the introduction of wide-angle viewing systems can help the surgeon perfor m safer and more effective retinotomy procedures. Materials and Method s: The authors retrospectively analyzed the records of patients underg oing retinotomy procedures between 1993 and 1995 and divided them into two groups according to the viewing system used during the retinotomy procedures. Group 1 included 86 eyes that underwent surgery between J uly 1991 and June 1993 with Lander's plano-concave and prismatic lense s (Optikon, Rome, Italy), and group 2 included 96 eyes that underwent surgery between July 1993 and June 1995 with the Advanced Vitreoretina l Instruments system (New York, NY). Outcome measures were divided int o preoperative (diagnosis at baseline, anterior proliferative vitreore tinopathy grade and extension, and visual acuity), intraoperative (siz e of retinotomy, number of laser spots, need for scleral depression, l ensectomy, intraocular lens and capsule removal, and duration of treat ment) and postoperative (anatomic success rates, visual acuity, postop erative intraocular pressure, and need for postoperative laser treatme nt and follow-up treatment). Results: Among preoperative parameters, t here were no significant differences between the two groups. For intra operative parameters, eyes in group 2 underwent significantly shorter surgical procedures, had less of a need for scleral depression, and, a s a group, had a higher average number of laser spots. For postoperati ve parameters, eyes in group 2 had a significantly lower need for lase r treatment at the edge of retinotomy after surgery. Conclusion: Our r esults suggest that the use of a panoramic viewing system significantl y decreases the time required for intervention, allowing more complete laser treatment along the edge of the retinotomy and lowering the nee d for scleral depression. The need for completion of laser treatment a long the edge of the retinotomy after surgery also is reduced signific antly, possibly increasing patient comfort because, especially in the early postoperative days, postoperative laser treatment can be extreme ly uncomfortable for the patient and difficult to perform for the surg eon. No prognostic benefit has been proven for any of the two groups b ecause anatomic and visual results were overlapped.