Primary Retinal Detachment
Primary Retinal Detachment
Primary Retinal Detachment
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2 Prophylaxis in Fellow Eye of <strong>Primary</strong> <strong>Retinal</strong> <strong>Detachment</strong> 29<br />
also concluded that “the incidence of second eye detachments does<br />
not decrease as the result of preventive treatment”. These data are<br />
summarized in Table 2.2.<br />
The special category of aphakic or pseudophakic fellow eyes<br />
has very little pertinent data from comparative studies in the literature<br />
comparing treated and untreated groups. However, such a<br />
study was reported in 1989 by Herzeel et al. [22] in which one of the<br />
groups was treated with encircling circumferential cryotherapy.<br />
They found that the treated group developed retinal detachment in<br />
2.3%; whereas, this outcome occurred in only 1.3% of the untreated<br />
group, leading the authors to say that “these results lead us to conclude<br />
that ‘prophylactic’ treatment does not necessarily prevent<br />
this complication”.<br />
A further category of fellow eyes that simultaneously harbor<br />
multiple risks has always represented a special group which has<br />
been thought to have a more marked vulnerability to detachment<br />
and therefore to be pre-eminently eligible for “prophylactic” treatment.<br />
However, Folk et al. [21] in 1989 reported comparison<br />
groups of fellow eyes, all of which had three simultaneous risk factors<br />
for retinal detachment (fellow eye status, lattice degeneration<br />
and high myopia). They found that “prophylactic” treatment of<br />
the lattice lesions did not confer any advantage in lowering the<br />
rate of detachments. Instead, apparently what happens is that,<br />
although the risk of detachment is higher with existing multiple<br />
risk factors, so also is the risk of secondary detachment following<br />
treatment.<br />
In fact the incidence of retinal detachment following “prophylactic”<br />
treatment is in approximately the same range as the rate of<br />
detachment in fellow eyes left untreated.<br />
Therefore, we may conclude that the earlier hope of preventing<br />
retinal detachment in fellow eyes by some form of “prophylactic”<br />
treatment has not been significantly substantiated, and this approach<br />
offers no more than a slight benefit.<br />
The significant visible predisposing lesions of the peripheral<br />
retina, related to retinal detachment, which are primarily lattice