Long-Term Outcomes of Laser Barricade for Large Rhegmatogenous Retinal Detachments

To evaluate long-term outcomes of in-office laser barricade for large (≥2 clock hours) rhegmatogenous retinal detachments (RRDs) and to report the frequency of additional laser treatment or pars plana vitrectomy (PPV).

A retrospective chart review was performed of patients treated between 2015 and 2023 at a retina-only private practice in Chicago, Illinois. Included cases were eyes with fundus diagram-confirmed RRDs involving ≥2 clock hours of circumference, and ≥3 months of follow-up. Procedure success was defined as RRD management without requiring PPV.

Seventy-six eyes of 72 patients (mean ± SD age, 52.1 ± 17.7 years) were analyzed, with a mean follow-up of 38.6 months. RRD size was a mean ± SD 2.9 ± 1.1 clock hours (range, 2-6). Mean best-corrected visual acuity (BCVA) was 20/31 at baseline and 20/30 at final follow-up. Procedure success rate was 92.1%, with 6 eyes (7.9%) requiring PPV. Thirteen eyes (17.1%) required additional laser barricade. Eyes with phakic lens status, worse baseline BCVA, vitreous hemorrhage, or baseline posterior vitreous detachment were more likely to require PPV, though these associations did not reach statistical significance (P = .06-.08). Laser barricade was performed on same day of diagnosis in 47 eyes (61.8%) and delayed by ≥1 day in 29 eyes (38.2%). Same-day treatment trended toward a higher need for PPV (P = .08 vs delayed treatment).

In-office laser barricade is an effective treatment for RRDs spanning ≥2 clock hours, with a 92.1% long-term success rate. Patients not requiring same-day intervention may achieve excellent outcomes with laser barricade alone.