Prophylactic Laser Retinopexy and Scleral Buckle Placement for Retinal Detachment Prevention in Pierson Syndrome: A Retrospective, Case Series Study.

Abstract

Purpose: To report the impact of prophylactic 360° laser retinopexy and scleral buckle placement for retinal detachment (RD) prophylaxis in patients affected by Pierson syndrome (PS).

Method: This retrospective case series included 11 PS patients (2015-2024), analyzing demographic data, ophthalmological exams, and genetic testing. Prophylactic interventions were compared with post-RD surgical interventions based on RD occurrence and timing. A one-sample proportion test evaluated outcome differences.

Results: This study of 11 PS patients evaluated the effectiveness of prophylactic 360° laser retinopexy and scleral buckle (SB) placement. Ten patients carried the LAMB2 c.440A>G mutation and had associated findings of thyroid and renal disease. All retinal detachments (RDs) were combined tractional retinal detachment (TRD) and rhegmatogenous retinal detachment (RRD) due to posterior tears. Eight eyes with TRD-RRD were actively treated with laser retinopexy and SB; six (75%) experienced re-detachments. In contrast, seven eyes with TRD-RRD were treated prophylactically, with 86.6% of eyes treated with laser retinopexy and 100% of those receiving additional SB placement maintaining retinal integrity over an average follow-up of 3.4 years. Prophylactically treated eyes had significantly fewer RD recurrences compared to those treated surgically after RD onset (p < 0.01), highlighting the benefits of early combined intervention in PS.

Conclusion: This study's results suggest a potential role for prophylactic laser retinopexy and subsequent scleral buckle placement to prevent RD among patients with a confirmed diagnosis of Pierson syndrome.