Prophylaxis for retinal detachment: evidence or eminence based?

Abstract

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. 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. 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. 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.