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Published on: July 6, 2015
SINGLE-PORT ILLUMINATED ENDOLASER FOR A LARGE RETINAL BREAK WITH LOCALIZED RETINAL DETACHMENT UNDER WIDE-ANGLE
1Department of Ophthalmology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea.
Purpose:
To evaluate the feasibility of single-port illuminated endolaser photocoagulation using wide-angle visualization with BIOM as a nonvitrectomy approach for treating peripheral large retinal tears with localized retinal detachment.
Methods:
A 60-year-old patient presented with a peripheral large retinal tear and localized retinal detachment (RD). Owing to media opacity and far peripheral location, barrier laser could not be completed with conventional laser delivery systems. Because of the potential risk of aggravating RD in the setting of a large retinal break with overlying vitreoretinal traction, external cryotherapy was not used. Instead, we used 25g single-port illuminated endolaser probe to complete the barrier laser photocoagulation around the retinal break and localized RD area with the assistance of scleral indentation using a 150° wide-angle BIOM system without vitrectomy.
Results:
The single-port illuminated endolaser approach provided enhanced visualization including extreme peripheral location of the retina while depressing the sclera, allowing for comprehensive laser coverage of the lesion. This effectively prevented the progression of RD and facilitated fluid absorption, ultimately leading to the resolution of the localized RD. At 4 months postlaser treatment, the patient's retina is stable with well-formed chorioretinal adhesion.
Conclusion:
When retinal breaks are located in the far periphery with severe VR traction and media opacity is present, completion of conventional laser treatment may be challenging. A 25 g single-port illuminated endolaser photocoagulation without vitrectomy under BIOM may serve as an effective treatment option.
