PROPHYLACTIC LASER RETINOPEXY AND SCLERAL BUCKLE PLACEMENT FOR RETINAL DETACHMENT PREVENTION IN PIERSON SYNDROME: A Retrospective, Case Series Study.

Abstract

To report the effect of prophylactic 360° laser retinopexy and scleral buckle placement for retinal detachment (RD) prophylaxis in patients affected by Pierson syndrome (PS). This retrospective case series included 11 PS patients (2015-2024), analyzing demographic data, ophthalmological examinations, and genetic testing. Prophylactic interventions were compared with post-RD surgical interventions based on RD occurrence and timing. A one-sample proportion test evaluated outcome differences. This study of 11 PS patients evaluated the effectiveness of prophylactic 360° laser retinopexy and scleral buckle placement. Ten patients carried the LAMB2 c.440A>G mutation and had associated findings of thyroid and renal disease. All RDs were combined tractional RD (TRD) and rhegmatogenous RD (RRD) due to posterior tears. Eight eyes with TRD-RRD were actively treated with laser retinopexy and SB; six (75%) experienced redetachments. By contrast, seven eyes with TRD-RRD were treated prophylactically, with 86.6% of eyes treated with laser retinopexy and 100% of those receiving additional scleral buckle placement maintaining retinal integrity over an average follow-up of 3.4 years. Prophylactically treated eyes had significantly fewer RD recurrences compared with those treated surgically after RD onset ( P < 0.01), highlighting the benefits of early combined intervention in PS. This study's results suggest a potential role for prophylactic laser retinopexy and subsequent scleral buckle placement to prevent RD among patients with a confirmed diagnosis of PS.