Primary Retinal Detachment

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found that eyes with pre-existing retinal breaks do not have any increased
risk of retinal detachment following PVD. The same was
true of eyes with pre-existing senile retinoschisis (N.E. Byer, unpublished
observations). In the group of eyes with pre-existing lattice
degeneration the onset of sudden PVD did lead to new retinal
tears in 24% (N.E. Byer, unpublished observations). In 76% of the
eyes with lattice degeneration, the occurrence of a PVD did not
produce any complication of any kind (N.E. Byer, unpublished observations).
However, in 50% of the lattice-eyes the new tears appeared
in “normal”-appearing retinal areas and, thus, could not
have been pretreated (using the “prophylactic” method) because
they would not have been detected.
In summary, the conscientious examination of patients with recent
symptoms of posterior vitreous detachment, followed by discovery
and treatment of new retinal tears, provides the capability
of preventing around 44% of rhegmatogenous retinal detachments.
The older practice of “prophylactically” treating eyes with
predisposing retinal lesions has led only to a disappointing and
questionable clinical benefit. That procedure should be officially
discarded, and the above much-preferred method should be recognized
as the proper standard of care. This then is the obvious and
available answer to the question of “What to DO” to prevent retinal
detachment.
References
2 Prophylaxis in Fellow Eye of Primary Retinal Detachment
1. Schepens CL (1947) A new ophthalmoscope demonstration. Trans Am
Acad Ophthalmol Otolaryngol 51:298–301
2. Meyer-Schwickerath G (1949) Ber. 55,Vers Deutsch Ophth Ges Heidelberg
3. Meyer-Schwickerath G, Fried M (1980) Prophylaxis of retinal detachment.
Trans Ophthalmol Soc UK 100:56–65
4. Haut J, Arne J, Khairallah M (1988) La prevention du decollement
idiopathique de la retine. Bull Soc Ophtalmol Fr 1:173