Three hundred sixty‐degree prophylactic laser retinopexy versus focal laser during rhegmatogenous retinal detachment repair: A systematic review and meta‐analysis

PURPOSE: To compare the anatomic, functional and safety outcomes of intra-operative 360-degree prophylactic laser retinopexy versus focal laser retinopexy during pars plana vitrectomy (PPV) for rhegmatogenous retinal detachment (RRD) and to assess the certainty of evidence. METHODS: PubMed, Web of Science and Scopus were searched on June 27, 2025. Randomized controlled trials and comparative observational studies evaluating 360-degree versus focal laser during PPV for RRD were included. Two reviewers independently extracted data and assessed risk of bias (ROB-2, NIH tools). Pooled analyses were conducted using random-effects models, and the certainty of evidence was graded using GRADE. The primary outcome was single-surgery anatomic success (SSAS). Secondary outcomes included best-corrected visual acuity (BCVA), intraocular pressure (IOP) and post-operative complications. RESULTS: = 0%, moderate certainty), cystoid macular oedema and macular hole were comparable between groups. CONCLUSION: Adjunctive 360-degree laser retinopexy during PPV for RRD was associated with higher SSAS without a measurable increase in post-operative complications. However, no improvement in visual acuity outcomes was observed. Given the predominance of observational evidence, further well-designed randomized trials are warranted to clarify the magnitude of benefit.