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

Purpose 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 degrees vs focal ELR. Methods 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 degrees ELR and group 2 received focal ELR. Postoperative vision and complications, including redetachment rate, macular oedema and epiretinal membrane formation, were also compared. Results 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). Conclusions 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.

Automated summary

This study compared the effects of 360-degree and focal endolaser retinopexy (ELR) on postoperative pupil diameter in patients undergoing pars plana vitrectomy (PPV) for rhegmatogenous retinal detachment (RRD). The results showed an increase in postoperative pupil diameter, with a greater change in the 360-degree ELR group. Moderate pupillotonia induced post-ELR was correlated to the extent of ELR and was less marked in pseudophakic eyes.