The Necessity of Prophylactic 360 Degree Laser Photocoagulation During Vitrectomy for Dropped Nucleus

The aim of this study is to analyse the role of the prophylactic 360 degree laser photocoagulation on vitrectomies for dropped nucleus, and to examine whether it is useful or harmful for the development of retinal detachment by evaluating a retrospective case series. The patients who performed pars plana vitrectomy (PPV) due to the development of dropped nucleus after phacoemulsification between 2003 and 2015 in three different centers were retrospectively reviewed. The mean age of 79 patients was 67.04±7.36 years (range, 51-82 years); 51.9% were female. 5 of the patients have retinal tear before pars plana vitrectomy. 6 of 9 patients with RD have proliferative vitreoretinopathy (PVR). 8 patients underwent PPV surgery for twice and 1 patient underwent pars plana vitrectomy surgery for three times. We determined that proliferative membranes originated from prophylactic laser border in patients with PVR. As a conclusion, prophylactic 360 degree laser photocoagulation is not necessary during vitrectomy for dropped nucleus. Excessive laser photocoagulation can lead PVR. Instead of this process, it should be paid attention for scanning the periphery of fundus for peripheral retinal breaks. If retinal breaks are encountered, at that time retinal breaks should be surrounded by laser photocoagulation.