CO₂ laser-assisted sclerectomy with sclerostomy for uveal effusion syndrome

Surgical treatment of idiopathic uveal effusion syndrome (UES) is challenging with high risks. CO₂ laser-assisted sclerectomy surgery (CLASS) is potentially a semiquantitative, quick and safe surgical option. This study aimed to describe the feasibility and early outcomes of CO₂ laser-assisted sclerectomy surgery (CLASS) with sclerostomy for idiopathic uveal effusion syndrome (UES).

This was a prospective descriptive case series. After fully exposed, the sclera was ablated with CO₂ laser beam repeatedly until a bluish hue was visible. A crescent blade was used to make scleral incision in the same plane with the floor of the scleral pool. The lamellar sclera was cut, and the scleral pool was enlarged. A 1 × 1 mm² sclerostomy was created in each sclerectomy bed with a 15 degree stab blade.

The technique was used in three eyes of three patients with UES and exudative retinal detachment (RD). After a mean follow-up of 410 days (range, 34-825 days), all patients demonstrated sustained improvement of RD, with complete resolution in two cases. No adverse events were observed during the extended follow-up period.

CLASS with sclerostomy appears to be a feasible and durable technique for UES in this small series, though further studies are warranted.