ENCIRCLING PANRETINAL LASER PHOTOCOAGULATION MAY PREVENT MACULAR DETACHMENT AFTER VITRECTOMY FOR PROLIFERATIVE DIABETIC-RETINOPATHY

Macular detachment due to peripheral retinal tears that occur after pa rs plana vitrectomy for proliferative diabetic retinopathy can result in severe visual loss despite successful retinal reattachment. The aut hors reviewed the records of three patients who developed peripheral s clerotomy-related rhegmatogenous retinal detachments one to six months after vitrectomy for proliferative diabetic retinopathy, despite the absence of detectable selerotomy-related retinal tears by indirect oph thalmoscopy and scleral depression at the conclusion of surgery. All t hree patients had received standard panretinal laser photocoagulation in a complete encircling pattern either prior to or during the initial vitrectomy. Clinically or echographically, each patient was seen to h ave a partial or complete annual peripheral sclerotomy-related rhegmat ogenous retinal detachment delimited to the equator. In each of these three cases, posterior extension of the peripheral retinal detachment into the macular area was prevented by the most anterior row of the ph otocoagulation scars. Standard panretinal laser photocoagulation appli ed in a complete encircling pattern may be useful in the prophylaxis o f macular detachment from selerotomy-related retinal tears that occur after vitrectomy for proliferative diabetic retinopathy.