Vitrectomy treatment of retinal detachments related to choroidal coloboma involving the disk.

PURPOSE: To evaluate the anatomical and functional outcomes of retinal detachment with choroidal coloboma involving the disk, by incising the entire intercalary membrane along the margin of the coloboma and displacing part of the macular retina to healthy retinal pigment epithelium (RPE), and then treating the entire margin of the RPE surrounding the coloboma with diode laser.

METHODS

Pars plana vitrectomy was performed in five eyes with retinal detachment resulting from choroidal coloboma involving the disk. The entire intercalary membrane along the margin of the coloboma was incised. Part of the intercalary membrane in the macular region remained, and together with the macular retina was displaced slightly to healthy RPE. Carefully titrated diode laser burns were applied in the functional border of the disk (the border of papillomacular bundle) to reduce the nerve fiber layer damage, and endolaser of three to four rows was performed along the border of the coloboma. Anatomical reattachment of the retina and visual acuity were measured.

RESULTS

At the end of 12 months after the first surgery, the rate of retinal reattachment was 100% (5 eyes), and visual acuity improved from a preoperative perception of light or hand movement to counting fingers in 2 eyes and 3 eyes retained preoperative visual acuity.

CONCLUSION

For these retinal detachment eyes with choroidal coloboma involving the disk, complete vitrectomy, incising the entire intercalary membrane along the margin of the coloboma and displacing part of the macular retina to healthy RPE, treating the entire margin of the RPE surrounding the coloboma with diode laser provides an effective treatment for this complicated type of retinal detachment with good long-term anatomical outcome.