Comparison of Results of Cryopexy and Laser Indirect Ophthalmoscopy in Rhegmatogenous Retinal Detachment

Hyun Park Chang; Hee Park Song; Jin Lee Sung

doi:10.3341/jkos.2008.49.11.1779

Journal List > J Korean Ophthalmol Soc > v.49(11) > 1008131

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Chang, Song, and Sung: Comparison of Results of Cryopexy and Laser Indirect Ophthalmoscopy in Rhegmatogenous Retinal Detachment

Original Article

J Korean Ophthalmol Soc 2008;49(11):1779-1783.

Published online: 7 September 2008

DOI: https://doi.org/10.3341/jkos.2008.49.11.1779

Comparison of Results of Cryopexy and Laser Indirect Ophthalmoscopy in Rhegmatogenous Retinal Detachment

Hyun Park Chang, M.D.,, Hee Park Song, M.D., Ph.D., Jin Lee Sung, M.D., Ph.D.

Department of Ophthalmology, Soonchunhyang University, College of Medicine, Seoul, Korea

Address reprint requests to Sung Jin Lee, M.D., Ph.D. Department of Ophthalmology, Soonchunhyang University Hospital 652 Hannam-dong Yongsan-gu, Seoul 140-743, Korea Tel: 82-2-709-9354, Fax: 82-2-798-7797, E-mail: wismile@unitel.co.kr

Received 28 August 2008 Accepted 9 January 2008

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To compare the efficacy and safety of intraoperative laser indirect ophthalmoscopy and cryopexy for rhegmatogenous retinal detachment through the use.

Methods

We retrospectively analyze the clinical results of 60 patients (61 eyes) with rhegmatogenous retinal detachment. All eyes had an attached macula and were scheduled for conventional scleral buckling surgery with cryopexy (25 eyes) or laser indirect ophthalmoscopy (36 eyes) from March 2001 to August 2007. The visual acuities of the two groups at the first postoperative day, 1 week, 1 month, and 3 months were compared. Retinal reattachment, macular pucker, cystoid macular edema, and proliferative vitreoretinopathy were confirmed 3 months after surgery.

Results

The visual recovery was faster in patients who received laser indirect ophthalmoscopy (1 day, P=0.044; 1 week, P=0.017). During the follow-up period, anatomical failure in the laser indirect ophthalmoscopy group did not develop, but there were two anatomical failures in the cryopexy group. In addition, 1 PVR was detected in the cryopexy group. However, neither group exhibited macular pucker or cystoid macular edema. Postoperative additional laser photocoagulation was performed on 7 eyes (19.4%) in thelaser indirect ophthalmoscopy group and 2 eyes (4.0%) in the cryopexy group.

Conclusions

Although intraoperative laser indirect ophthalmoscopy causes less chorioretinal scar formation than cryopexy, it has a higher anatomical success rate and allows for faster visual recovery.

Keywords: Cryopexy, Laser indirect ophthalmoscopy, Photocoagulation, Retinal detachment, Scleral buckling

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Figure 1.

Visual recovery. LIO=laser indirect ophthalmoscopy; CRYO=Cryopexy; logMAR VA=logarithm of minimal angle of resolution visual acuity; preop=before surgery; wks=weeks; mons=months.

Table 1.

Preoperative and perioperative features of two study groups with rhegmatogenous retinal detachment

Characteristics	LIO^* group (n=36)	Cryo^† group (n=25	) P value	Test type
Mean age, yr (mean±SD	) 31.92±11.27	36.88±13.41	0.176	Mann-Whitney test
Sex (M/F)	17/19	12/13	0.952	Pearson chi-square test
IOP^‡(Mean±SD)	15.31±2.69	16.08±2.75	0.220	Mann-Whitney test
R.E^§ (mean±SD)	-5.38±5.71	-4.92±4.23	0.626	Mann-Whitney test
P^∏/PS^#/AP^#	34/0/2	23/2/0	0.763	Chi-square test (linear-by-linear association)

^* LIO=laser indirect ophthalmoscopy

^† Cryo=cryopexy

^‡ IOP=intraocular pressure

^§ R.E=refractive error

^∏ P=phakic

^# PS= pseudophakic

^** AP=aphakic.

Table 2.

LogMAR visual acuity before and after surgery (Mann-Whitney test, P<0.05)

	LIO^* group (mean±SD)	Cryo^† group (mean±SD)	P-value
Before surgery	0.15±0.17	0.20±0.31	0.967
Day 1	0.49±0.46	0.64±0.34	0.044
Day 7	0.23±0.28	0.31±0.21	0.017
4 weeks	0.11±0.16	0.12±0.13	0.342
3 months	0.04±0.10	0.04±0.07	0.369

^* LIO=laser indirect ophthalmoscopy

^† Cryo=cryopexy.

Table 3.

Influence of intravitreal SF₆ gas injection and subretinal fluid drainage on postoperative visual acuity ( P value)

	Day 1	Day 7	4 wks^∏	3 mons^#
SF₆^* gas in LIO^†(n=6)	0.606	0.258	0.140	0.350
SRFD^‡ in Cryo^§ (n=5)	0.055	0.757	0.482	0.169

^* SF₆=sulfur hexafluoride

^† LIO=laser indirect ophthalmoscopy

^‡ SRFD=subretinal fluid drainage

^§ Cryo=cryopexy

^∏ wks= weeks

^# mons=months; Mann-Whitney test, P<0.05.

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