Preventing Retinal Detachment: The Encircling Laser Retinopexy Technique

Abstract

Encircling (360 degree) retinal detachment prophylaxis using indirect ophthalmoscope laser delivery recently achieved strong proof of safety and effectiveness by preventing the development of peripheral retinal tears and detachments in the eyes of patients with Stickler syndrome (syndromic eyes). Untreated, Stickler syndrome patients have a 65% lifetime risk of retinal detachment (half by age 20, 80% bilateral). This report describes an optimal technique of encircling laser retinopexy to also prevent the more common retinal detachments seen in aging (non-syndromic) eyes that share with Stickler syndrome the common pathogenesis of peripheral retinal tears caused by vitreous traction.

Video abstract

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Keywords:

• retinal tear
• retinal detachment
• retinal detachment prevention
• 360-degree laser retinopexy
• encircling laser prophylaxis
• ora secunda cerclage
• Stickler syndrome

Acknowledgments

Christina Sullivan assisted in manuscript preparation and video editing. Laura Beckwith, Dewayne Conn, and Jessica Haynes provided substantial assistance in administration and clinical care, for which we are grateful. The staff of the UAB Callahan Eye Hospital operating rooms expertly assisted us in refining our treatment techniques. Bernard Dib, MD aided with video and photography. All photographic images are courtesy of Retina Specialists of Alabama LLC, and illustrations are with permission of artist Stephen Gordon.

Disclosure

Dr. Robert Morris is President of the Helen Keller Foundation for Research and Education, Birmingham, Alabama, USA. Dr. Ferenc Kuhn is the Foundation’s Director of Clinical Research and Chairman of the International Society of Ocular Trauma. Drs. Morris and Kuhn are vitreoretinal surgeons and longtime research collaborators in ocular trauma, macular surgery, endophthalmitis, and retinal detachment. Dr. Cole Richardson is a fellow at Retina Specialists of Alabama, Birmingham, Alabama, USA. The authors report no other conflicting interests with respect to this study.

Additional information

Funding

Support for this article was provided by the Helen Keller Foundation for Research and Education, through grants from the Hanna Charitable Trust; the Kent Companies of Midland, Texas; and the Gary Christ trust benefitting the Foundation.