Influence of Intraoperative Retinal Laser Photocoagulation Area and Localisation on the Complications Frequency of Surgical Treatment for Diabetic Retinopathy

Relevance . Retinal laser photocoagulation (RLP) for proliferative diabetic retinopathy (PDR) is an important component of treatment at various stages including vitreoretinal surgery. The issue of the optimal intraoperative RLP area and localisation does not have a consensus; therefore, its clarification is an urgent task. Purpose : to evaluate the effect of intraoperative RLP area and localisation on the incidence of PDR surgical treatment complications. Patients and methods . The difference was in the use, area and localisation of RLP application: in group 1, RLP was not performed; in group 2, panretinal RLP was performed in four quadrants on the near and middle periphery (1000–1500 coagulates); in group 3, peripheral RLP was performed from the retinal equator to the ora serrata (600–800 coagulates). Intermediate treatment results were assessed within 1 month of surgery, and long-term results — after 12 months. Results . In the early postoperative period there were no statistically significant differences between groups. In the long-term follow-up period group 1 revealed a higher incidence of vitreous haemorrhage and anterior segment neovascular complications — rubeosis iridis and neovascular glaucoma. An unexpected increase in the incidence of diabetic macular edema in the long-term period after panretinal intraoperative RLP. The lowest frequency of complications was found in group 3 (after peripheral RLP). Conclusion . The study obtained and confirmed previously identified data on an increased risk of developing postoperative complications (vitreous haemorrhage, rubeosis iridis and neovascular glaucoma) in patients whose treatment did not include intraoperative RLP. The lowest frequency of complications was found in the group after peripheral RLP, which makes the proposed coagulation method promising in terms of application and further study.