Pupillotonia after endolaser retinopexy during vitrectomy for retinal detachment: a prospective cohort study comparing circumferential and focal retinopexy.

Abstract

PURPOSE:

To determine differences in postoperative pupil diameter in eyes that undergo pars plana vitrectomy (PPV) for rhegmatogenous retinal detachment (RRD) with endolaser retinopexy (ELR), comparing 360° vs focal ELR.

METHODS:

Patients with uncomplicated RRD who underwent PPV were prospectively analysed regarding the postoperative pupil diameter difference (PDD) between the affected eye and the partner eye. Group 1 underwent 360° ELR and group 2 received focal ELR. Postoperative vision and complications, including redetachment rate, macular oedema and epiretinal membrane formation, were also compared.

RESULTS:

A total of 72 patients, 42 in group 1 and 30 in group 2, were analysed. PDD, as observed at 6 weeks, was significantly greater than the preoperative values in both groups 1 and 2. It increased by a mean of 1±1.11 mm in group 1 and by 0.5±0.78 in group 2. This initial increase in PDD receded over time, but remained statistically significant in both groups, even at 6 months. The top 20% of patients with the largest PDD change comprised 13 out of 15 eyes from group 1, which was a statistically significant overrepresentation (p=0.0435).

CONCLUSIONS:

Moderate pupillotonia was induced post-ELR in vitrectomy and correlated to the extent of ELR. The pupillotonia effect of ELR was significantly less marked in pseudophakic eyes.

• Authors: Christos Skevas, David Thiwa, Karl-Ulrich Bartz-Schmidt, Toam Katz, Martin Spitzer, Spyridon Dimopoulos
• Journal: The British journal of ophthalmology (Br J Ophthalmol) Vol. 107 Issue 12 Pg. 1900-1906 (11 22 2023) ISSN: 1468-2079 [Electronic] England
• PMID: 36288913 (Publication Type: Journal Article)
• Copyright: © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Topics

• Humans
• Retinal Detachment (surgery, etiology)
• Vitrectomy (adverse effects)
• Tonic Pupil (complications, surgery)
• Prospective Studies
• Visual Acuity
• Retrospective Studies