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Skevas, Christos; Thiwa, David; Bartz-Schmidt, Karl-Ulrich; Katz, Toam; Spitzer, Martin; Dimopoulos, Spyridon

Pupillotonia after endolaser retinopexy during vitrectomy for retinal detachment: a prospective cohort study comparing circumferential and focal retinopexy

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  • Media type: E-Article
  • Title: Pupillotonia after endolaser retinopexy during vitrectomy for retinal detachment: a prospective cohort study comparing circumferential and focal retinopexy
  • Contributor: Skevas, Christos; Thiwa, David; Bartz-Schmidt, Karl-Ulrich; Katz, Toam; Spitzer, Martin; Dimopoulos, Spyridon
  • imprint: BMJ, 2023
  • Published in: British Journal of Ophthalmology
  • Language: English
  • DOI: 10.1136/bjo-2022-321640
  • ISSN: 1468-2079; 0007-1161
  • Keywords: Cellular and Molecular Neuroscience ; Sensory Systems ; Ophthalmology
  • Origination:
  • Footnote:
  • Description: <jats:sec><jats:title>Purpose</jats:title><jats:p>To determine differences in postoperative pupil diameter in eyes that undergo pars plana vitrectomy (PPV) for rhegmatogenous retinal detachment (RRD) with endolaser retinopexy (ELR), comparing 360° vs focal ELR.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>Patients with uncomplicated RRD who underwent PPV were prospectively analysed regarding the postoperative pupil diameter difference (PDD) between the affected eye and the partner eye. Group 1 underwent 360° ELR and group 2 received focal ELR. Postoperative vision and complications, including redetachment rate, macular oedema and epiretinal membrane formation, were also compared.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>A total of 72 patients, 42 in group 1 and 30 in group 2, were analysed. PDD, as observed at 6 weeks, was significantly greater than the preoperative values in both groups 1 and 2. It increased by a mean of 1±1.11 mm in group 1 and by 0.5±0.78 in group 2. This initial increase in PDD receded over time, but remained statistically significant in both groups, even at 6 months. The top 20% of patients with the largest PDD change comprised 13 out of 15 eyes from group 1, which was a statistically significant overrepresentation (p=0.0435).</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>Moderate pupillotonia was induced post-ELR in vitrectomy and correlated to the extent of ELR. The pupillotonia effect of ELR was significantly less marked in pseudophakic eyes.</jats:p></jats:sec>