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No Clear Benefits from Prophylactic Retinopexy

Patient education on detachment symptoms more important

MONDAY, July 10 (HealthDay News) -- Patient education on the early warning signs of retinal tears and detachment is more effective for high-risk patients than prophylactic retinopexy, which has no clearly proven benefits and may cause harm, according to a study published in the July issue of the Archives of Ophthalmology.

Devinder S. Chauhan, F.R.C.Ophth., M.D., of Moorfields Eye Hospital in London, and colleagues analyzed data from 17 patients treated for retinal breaks or detachment that occurred subsequent to prophylactic retinopexy performed at the same time as primary rhegmatogenous retinal detachment surgery. Follow-up treatment included cryotherapeutic and laser retinopexy, scleral buckling and vitrectomy.

In six cases, only retinopexy was used. Sixteen patients (94 percent) developed retinal tears that were related to acute posterior vitreous detachment, including eight (47 percent) at the edge of retinopexy and eight in the normal or untreated retina. In all, 13 patients (76 percent) developed retinal detachment, including 11 (85 percent) that did not involve the fovea.

The investigators conclude that prophylactic retinopexy "is not completely successful" in fellow eyes without posterior detachment and they recommend mandatory patient education instead. Patients should be warned of the symptoms of vitreous and retinal detachment. They should have a clear understanding of the need to seek prompt ophthalmic review to exclude retinal tear and detachment formation, the authors conclude.

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