360° versus localized demarcation laser photocoagulation for macular-sparing retinal detachment in silicone oil-filled eyes with undetected breaks: A retrospective, comparative, interventional study.

BACKGROUND AND OBJECTIVE: Recurrent retinal detachment (RD) in silicone oil-filled eyes is a serious condition. At the initial stage, it usually spares the macular and is localized in the inferior retina. The inability to locate the retinal breaks has been reported to be associated with a poor prognosis and has limited the use of conventional vitreoretinal surgeries. Demarcation laser photocoagulation (DLP) is widely accepted for treating macular-sparing RDs. For laser treatments to be effective, an adequate extent and the correct placement of the laser is of great importance. The purpose of this research was to compare the efficacy of 360° and localized DLP in the management of macular-sparing RD in silicone oil-filled eyes with no detected retinal breaks.

MATERIALS AND METHODS: This is a retrospective, comparative, interventional study. The medical records of 48 consecutive eyes with macular-sparing RD in silicone oil-filled eyes with no detected retinal breaks were reviewed. Twenty-six patients (group I) received 360° DLP, and the remaining 22 patients (group II) underwent localized DLP. The anatomical and visual outcomes of the two groups were compared.

RESULTS: The mean follow-up period was 12.54 ± 1.17 months. No significant difference was identified in the baseline characteristics. The single-operation success rate of 92.31% was achieved in group I, which was significantly higher than that of group II (59.09%, P = 0.01), and this trend was not weakened after adjusting for confounding factors (odds ratio: 0.002, P = 0.02). After salvage management of vitreoretinal surgeries, both groups had equivalent visual outcomes with silicone oil removal. Multivariate logistic regression also indicated that the radial extent of RD (odds ratio: 11.10, P = 0.04) was an independent predictor for laser treatment failure. Significant complications sufficient to require further operations included proliferative vitreoretinopathy in two (4.17%) eyes and epiretinal membrane in four (8.33%) eyes.

CONCLUSIONS: The 360° DLP achieved a better primary success rate and equivalent visual outcomes with localized DLP for macular-sparing RD in silicone oil-filled eyes with no detected retinal breaks.