Decoupled Endoscopy and Endolaser for Retinal Detachment Repair in Eyes With Corneal Opacity

Background and Objective: Standard ocular endoscopes mechanically lock imaging and 810-nm infrared laser fibers together in endoscopy probes ideal for cyclophotocoagulation. These systems can be adapted for modern posterior segment surgery by decoupling imaging from photocoagulation using a conventional 532-nm green-light endolaser probe. In this study, the results of this method in endoscopy-assisted pars plana vitrectomy (E-PPV) were evaluated. Patients and Methods: A retrospective chart review was conducted of 64 patients with rhegmatogenous retinal detachments (RRDs) and corneal opacities that precluded operating microscope PPV. All patients underwent E-PPV with 532-nm endophotocoagulation between 2017 and 2025 and had at least one year of postoperative follow-up. Results: One-year single-surgery anatomic success without additional surgery was 78.4% in eyes with preoperative proliferative vitreoretinopathy (PVR) and 84.6% in eyes without PVR. Conclusion: Decoupling endoscopy from endophotocoagulation with a 532-nm endolaser is effective for RRD repair in eyes with corneal opacity. This approach overcomes the vitreoretinal surgery disadvantages of standard endoscopes because it obviates the need for repositioning and readjusting the endoscope after each retinal burn, provides distinct 532-nm laser lesions for power titration, and permits contemporary repetitive-pulse and multispot photo-coagulation.