Comparative study of endolaser versus cryocoagulation in vitrectomy for rhegmatogenous retinal detachment

To investigate the influence of different types of retinopexy on the outcome of rhegmatogenous retinal detachment (RRD) repair.

All patients with RRD who underwent pars plana vitrectomy (PPV) between January 2013 and December 2017 were included. Analysed surgical factors were types of retinopexy (cryocoagulation, endolaser, combined). Subgroup analysis was performed in patients with primary proliferative vitreoretinopathy (PVR), and/or the necessity of a primary silicone oil fill.

A total of 1017 eyes with retinal detachment were included. The predominant type of retinopexy used during PPV was cryocoagulation in 492 eyes, followed by a combined cryocogulation/endolaser in 306 eyes and laserretinopexy in only 219 eyes. Overall, the re-detachment rate was 10.1%. In most of the cases (53.6%) the main reason for re-detachment was insufficient retinopexy, followed by a PVR-reaction in 37.3%, and new site break in 9.1%. No significant difference in the rate of re-detachment was found between the different types of retinopexy (p = 0.309). However, subgroup analysis showed a significantly higher rate of re-detachment in patients with a primary PVR (p = 0.0003), and in the group with silicone oil as the primary tamponade (p = 0.0001).

The data suggests that the type of retinopexy has little relevance for the surgical outcome of PPV for the primary RRD. However, patients with primary PVR and primary silicone oil fills were at a significantly increased risk for re-detachment.