Prophylaxis for retinal detachment: evidence or eminence based?

Retina. 2007 Apr-May;27(4):468-72. doi: 10.1097/01.iae.0000243069.11708.f6.

Abstract

Purpose: Prophylactic laser treatment of peripheral retinal lesions to prevent retinal detachment enjoys widespread use. However, clinical and scientific evidence for such treatment only exists for a few particular clinical situations. The aim of the present study was to delineate the current practice patterns for such prophylaxis among some European retinal specialists.

Methods: A postal survey was conducted among all members of BEAVRS (British and Eire Association of Vitreoretinal Surgeons; n = 236), all members of the German Retinological Society (n = 396), and Swiss retinal surgeons (n = 12) using a questionnaire with 6 case scenarios. The retinal specialists were asked to choose between three different options for each case: treat retinal lesion prophylactically, clinical follow-up, and other options.

Results: The return rates of the questionnaire were 36% in the United Kingdom, 42% in Germany, and 83% in Switzerland. There was a general tendency to apply laser prophylaxis to peripheral retinal lesions despite the absence of evidence in the medical literature.

Conclusions: Nonevidence-based prophylactic laser treatment of peripheral retinal lesions remains a clinical and economic issue that must be addressed, and more evidence-based data are needed to establish clear clinical guidelines. Swiss retinal specialists are particularly conscientious in sending back a medical questionnaire.

MeSH terms

  • Adult
  • Aged
  • Europe
  • Evidence-Based Medicine
  • Health Knowledge, Attitudes, Practice*
  • Health Surveys
  • Humans
  • Laser Coagulation / methods*
  • Middle Aged
  • Practice Patterns, Physicians'*
  • Retinal Detachment / surgery*
  • Societies, Medical / trends
  • Surveys and Questionnaires