There has been multiple guidelines and vast controversies regarding Prophylactic Laser of Lattice degeneration. I wanted to know what do senior surgeons and colleagues follow in their practice.?
Following Prof. Susan Binder - Retinal Specialist in Vienna it is not advised to do prophylactic laser in this case
Asymptomatic lattice (minus floaters /flashes ) can be left alone and only followed up.
yes sir, it is not recommended, you can go ahead with cataract surgery without any hesitation.
Asymptomatic Incidental Lattice Degeneration need not be lasered .It should be followed up. When they are associated with retinal holes, tears or detachments, then the treatment of those conditions may dictate the course of action for lattice lesions
In our department we don't treat asymptomatic degenerations in these cases. If there are retinal holes or tears, we would certainly treat those first
I'll be the contrarian: In general, I agree. However, you might consider it in younger men. Younger myopic men with lattice are at much higher risk for RD after cataract surgery, especially if there is capsular rupture (which most surgeons don't plan). Prophylactic laser retinopexy is generally safe and simple, and in this particular type of patient it may be a good idea. I also try to get the cataract surgeons to avoid silicone IOLs in patients like this, who are at increased risk for needing a vitrectomy.
I totally agree with Dr. Luttrull
In young patients with high myopia and lattice degeneration, posterior capsule breach and vitreous prolapse should be avoided at all costs.
Another concern is that it would be rather difficult, painful and hazardous to have post operative laser retinopexy (contrary to pre-operatively), in case of the development of retinal break in the encounter of a complicated surgery. Let alone the difficulty in examination that might really preclude proper identification of the break in due time.
The cornea is cloudy (especially in vitreous prolapse), wound is still open and the eye is sore and it might take some time to heal, during which a break might progress to RRD
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