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- W2023396247 abstract "In their article about retinal breaks and detachments after neodymium:YAG (Nd:YAG) laser posterior capsulotomy,1 Ranta and coauthors address the issue of prophylactic treatment of asymptomatic retinal tears prior to Nd:YAG capsulotomy in pseudophakic eyes. The authors state that retinal detachments (RDs) occurred in 1.2% (2 of 211 eyes) of prophylactically treated eyes and in 5.8% (6 of 171 eyes) of untreated eyes and conclude that prophylactic photocoagulation of preexisting retinal breaks is worth considering, especially in high-risk eyes. However, the prospective study they report was not randomized and 75% of the untreated eyes had other risk factors for RD (long axial length, history of retinal detachment, posterior capsule rupture and loss of vitreous at the time of surgery). Furthermore, the 2 retinal breaks that occurred in the prophylactically treated eyes occurred in sites that were not related to the previously noted and treated asymptomatic breaks. The authors further state that 62.5% (5 of 8) of the RDs in the study resulted from new retinal breaks and not from preexisting lesions. If retinal breaks were occurring after Nd:YAG capsulotomy from sites that were deemed normal before capsulotomy, how can prophylactic laser treatment to asymptomatic retinal breaks be beneficial? The American Academy of Ophthalmology Preferred Practice Pattern2 states that demonstrating that vitreoretinal lesions increase the risk for RDs does not justify their prophylactic treatment in the absence of scientific evidence that therapy lowers the rate of subsequent RD. There is also evidence that retinal tears develop in areas adjacent to previous prophylactic treatment.3 We therefore think the evidence for the prophylactic treatment of preexisting retinal breaks before Nd:YAG capsulotomy presented by Ranta and coauthors is unconvincing and potentially misleading. Shabbir Harun MRCOphth Balakrishna V. Kumar FRCSE Som D. Prasad FRCSE Upton, United Kingdom" @default.
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- W2023396247 date "2005-08-01" @default.
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- W2023396247 title "Retinal breaks and detachment after neodymium:YAG laser posterior capsulotomy" @default.
- W2023396247 cites W2084570720 @default.
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- W2023396247 doi "https://doi.org/10.1016/j.jcrs.2005.08.019" @default.
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