Home About us Editorial board Ahead of print Current issue Search Archives Submit article Instructions Subscribe Contacts Login 
  • Users Online: 568
  • Home
  • Print this page
  • Email this page

   Table of Contents      
ARTICLES
Year : 1983  |  Volume : 31  |  Issue : 7  |  Page : 961-963

Laser photogoaculation and prophylactic treatment for retinal detachment of the lesion


Senior Ophthalmic Surgeon, Jaslok Hospital and Research Centre, Mumbai, India

Correspondence Address:
Kanti Mody
Senior Ophthalmic Surgeon, Jaslok Hospital and Research Centre, Mumbai
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


PMID: 6544298

Rights and PermissionsRights and Permissions

How to cite this article:
Mody K, Saxena A. Laser photogoaculation and prophylactic treatment for retinal detachment of the lesion. Indian J Ophthalmol 1983;31, Suppl S1:961-3

How to cite this URL:
Mody K, Saxena A. Laser photogoaculation and prophylactic treatment for retinal detachment of the lesion. Indian J Ophthalmol [serial online] 1983 [cited 2020 May 24];31, Suppl S1:961-3. Available from: http://www.ijo.in/text.asp?1983/31/7/961/29717

The prophylactic Management of Retinal Detachment consists of (1) Recognition and assessment of the lesions, tears and degene­rations; (2) Evaluation of the risk factors and (3) The treatment of those lesions which would otherwise lead to Retinal Detachment.

Clinical Study at Eye Department of Jaslok Hospital and Research Centre, Bom­bay, was conducted on the Value of Laser Photocoagulation as a method of Prophylac­tic Treatment for retinal Detachment.


  Methods and material Top


(a) Case Selections: Eligibility for the Treat­ment of Eye.

1. Tears/Holes with Symptoms (20 Eyes)

Tears/Holes with Vitreous Traction and

Posterior Vitreous Detachment.

(16 Eyes)

2. Tears/Holes in Aphakic Eyes (6 Eyes)

3. Tears/Holes in Myopic Eyes (10 Eyes)

4. Tears/Holes in Fellow Eyes (15 Eyes)

5. Retinal Dialysis without Retinal

Detachment (1 Eye)

6. Lattice Degeneration (12 Eyes)

a) Same eye or fellow eye with retinal

detachment (8 Eyes)

b) Presence of aphakia, myopia and

giant tear (8 Eyes)

c) Prior to the cataract surgery (3 Eyes)

7. Snail Track Degeneration (2 Eyes)

8. Fellow Eye of Giant Tear (2 Eyes)

9. Combination of more than one of the above condition.

Total Eyes: 40

(b) Pre-treatment Evaluation and Assessment.

1. Complete History and Ophthalmic Clinical Examination of both Eyes with fully dilated pupils.

2. Most important-3 mirror contact lens Biomicroscopy and Indirect Ophthal­moscopy with $cleral Indentation.

(c) Following factors were considered for Evaluation and Assessment:

1. Size, shape and location of the tear and the degeneration.

2. Presence or absence of the surround­ing pigment.

3. Refractive Error (Myopia, Aphakia etc.)

4. Condition of the Vitreous (Posterior Vitreous Detachment, traction etc.)

5. Previous Retinal Surgery in the involved eye.

6. Anticipated Cataract Surgery.

7. Fellow Eye.

8. Family History.

(d) Treatment - Equipments and Technique

Argon Laser attached to Haag-Streit Slit Lamp.

-Local Surface Anaesthesia.

-Contact Lens-3 mirror Goldman's

Contact Lens. -Pupil-full dilatation.

-Laser Parameters

Power : 500 to 600 mw. (mills watts)

Size : 300 to 500 micron spot size.

Duration: 0.07 to 0.12 seconds.

Burn : Grade III-but not chalky

white

Patterns :-Two to three rows of burns around the tear or degeneration.

-Not to treat the actual area of tear or degeneration.

-Burns touching each other, or a small gap between the two burns.

-Complete encirclement of the lesions with laser burns.

-Horse-shoe Tear: Com­pletely cover the lesion including special care to cover anterior aspects.

Lattice & Snail Track Degeneration: To treat

these lesions by covering with burns all around, but it is important not to treat the sctual lesion. Keep a small distance away from the edge of the degeneration (in view of the vitreous attachment and traction).

(e) Post Laser Treatment:

1. 0101-Antibiotic Steroid drops or oint­ment four times a day for 10-14 days. -To keep the pupil dilated with mydriatic. -Analgesics if required.

2. Patch or dark glasses (if patient com­mplains of photophobia).

3. Gentle activities may be allowed. Bed rest is not required.

4. Patient should instructed to report pro­mptly on the symptoms e.g. more floaters, more flashes, "Clouds and Cur­tains", sudden loss of vision or field of vision.

(f) Follow-up Examination

The treated eyes were examined at the following intervas: 1 week, 3 weeks, 6 weeks, 3 months, 6 months and then if required.

Follow-up period for the eyes treated ranged from 6 months to 18 months.


  Observation Top


Aim of the Prophylaxis was achieved in all

Cases i.e.

-there was no retinal detachment in any of the teated eye. This method was as effective as other methods.

This method was as effective as other methods.

Complications: Nil. Benefits ofArgon Laser­

1. It is a convenient, safe, comfortable, OPD procedure requiring only local anaesthesia.

2. Post treatment period is short and patient experience minimum discomfort.

3. Accurate and easy localisation of the lesion for the laser photocoagulation.

4. Conjunctiver chemosis, conjunctival laceration, retinal and choroidal haemorr­hage as well as choroidal detachment­These side effects were not observed.

5. Macular pucker a more serious complica­tion is unlikely to occur with laser photo­coagulation compared to that with other procedures.

(None of the treated eyes developed this complication).

Following factors are not favourable for Laser Photocoagulation as Method of Prophylactic Treatment.

1. Hazy Media-Cornea, Lens (peripheral opacities) Vitreous haemorrhage and opacities.

2. Poor Pupil dilatation.

3. Tear/Holes with subretinal fluid even if it be shallow.


  Conclusion Top


This study has shown that laser photo­coagulation as a method of prophylactic treatment for retinal detachment is quite effective, safe, convenient, comfortable, out patient (office) procedure requiring local sur­face anaesthesia. Its technique provides accurate and relatively easy localisation ofthe lesion and its photocoagulation. Side effects and complications were not observed, though low incidence of a few complications are reported in the literature.




 

Top
 
 
  Search
 
    Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
    Access Statistics
    Email Alert *
    Add to My List *
* Registration required (free)  

 
  In this article
Methods and material
Observation
Conclusion

 Article Access Statistics
    Viewed3926    
    Printed44    
    Emailed1    
    PDF Downloaded0    
    Comments [Add]    

Recommend this journal