Retinal detachment following prophylactic laser retinopexy in patients with lattice degeneration: a real-world TriNetX analysis

To evaluate rhegmatogenous retinal detachment (RD) or retinal break incidence after prophylactic laser retinopexy in patients with lattice degeneration using TriNetX.

This retrospective cohort study identified patients with lattice degeneration and compared those who underwent prophylactic laser retinopexy within three-months of diagnosis with untreated patients. Patients with prior RD, ocular trauma, intraocular lens procedures, or posterior segment surgery were excluded. Propensity score matching was performed using demographic characteristics, ocular risk factors, and systemic comorbidities. Outcomes were assessed beginning 30 days after the index date. The primary outcome was laterality-specific RD with retinal break, while secondary outcomes included non-laterality-specific RD with retinal break and any RD or retinal break. A case-control analysis evaluated factors associated with RD.

After propensity score matching, 873 patients remained in each cohort. The primary outcome, laterality-specific RD with retinal break, occurred in 27 treated and 13 untreated patients, with incidences of 3.1% and 1.5%, respectively. RD with retinal break occurred in 91 treated and 56 untreated patients, with incidences of 10.4% and 6.4%. The broader composite outcome of any RD or retinal break occurred in 535 treated and 144 untreated patients, with incidences of 61.3% and 16.5%. Case-control analysis showed RD with retinal break was associated with older age, male sex, vitreous degeneration, degenerative myopia, and intraocular lens procedures.

Patients undergoing prophylactic laser had a higher observed incidence of subsequent retinal detachment or retinal break; however, substantial residual confounding by indication limits comparative interpretation, and these findings should not be considered evidence that prophylactic laser increases retinal detachment risk.