Non-Invasive Encircling Laser Treatment Can Help Prevent Retinal Detachment

By MArti WeBB slAy

Ophthalmologist Robert Morris, MD, founding physician of Retina Specialists of Alabama and president of the Birmingham-based Helen Keller Foundation for Research and Education, has documented a non-invasive laser treatment that can reliably prevent most retinal detachments in eyes known to be at high-risk.

Since retinal detachment is the leading cause of sudden sight loss in the aging eye, Morris wants fellow phy- sicians to be aware of the procedure for their patients who have a history of retinal detachment.

The procedure entails using a laser to weld the peripheral retina to the eye wall, effectively preventing tears that can cause blinding retinal detachments.

“This encircling laser treatment has been around for quite a while,” Morris said. “But nobody has defined exactly how to do it, and we have.”

Knowing how to best do the procedure is only the first step, however. Knowing when to do it is also important. Most adult patients with retinal detachment get their macular vision back, but many don’t. For those patients, the insurance of this procedure on their remaining good eye is an important consideration.

Others are at risk for retinal detachment as well. “There are a lot of risk factors for people getting a detachment,” Morris said. “One is if you have had a cataract extraction. (You should not avoid a cataract extraction, however, because the risk is still low.) Also, people who are highly nearsighted, and people who have a family history of retinal detachment. But if you look at all those risk factors together, it’s still hard to quantify how high a risk each patient faces.

“We’ve shown that if a patient and their doctor decide they are at an un- acceptably high risk after evaluating all these factors, then there is a treatment that is not invasive which can reliably prevent detached retina. We’re not telling doctors who should get it. That’s ultimately a decision the patient has to make when they are fully informed. That’s something a doctor and a patient may discuss over many visits.”

Because it can be difficult to assess who is at risk for retinal detachment, proving this procedure could prevent it was elusive, until Morris was visited in 2012 by a father and son with Stickler Syndrome. Stickler Syndrome is a rare, inherited disease affecting children and teenagers. “Retinal detachment

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