Peripheral scatter photocoagulation in the treatment of pars planitis

Purpose. We have previously shown that peripheral scatter photocoagulation (PSP) decreased neovascularization of the vitreous base (NVVB) in patients with pars planitis, and noted that it appeared to decrease inflammation and improve acuity, as well. We now present the long-term results of PSP in patients with pars planitis with and without NVVB. Methods. Nine patients (14 eyes) presented with vitritis unresponsve to corticosteroid treatment. Eleven eyes had NVVB, 8 eyes had CME, 4 eyes had vitreous hemorrhage, and 1 eye had NVD. Six patients (9 eyes) received PSP alone, while three patients (5 eyes) underwent pars plana vitrectomy and PSP. Results. Pretreatment visual acuity ranged from 20/20-20/200 (average=20/50). The duration of follow-up averaged 19 months (range, 2 to 35 months). Visual acuity after treatment ranged from 20/20-20/300 and improved an average of 0.43 lines with treatment. In 3 of the 4 cases with worsened vision, the decrease in visual acuity was due to cataract or posterior capsule opacity. Only one of the treated patients had an active vitritis that was responsible for the limited vision. When the cases with cataract and posterior capsule opacity were excluded, visual acuity after laser averaged approximately 20/30. This represents a gain of 2 lines of acuity per patient. Complications were minimal; however, 1 patient developed a tonic pupil in the treated eye. Cataract developed in 4 patients, 2 of whom had undergone vitrectomy, and 2 of whom had only PSP. Conclusions. Peripheral scatter photocoagulation is helpful not only in decreasing NVVB, but also improves vision in patients with pars planitis. It is a safe procedure with minimal risk of complication.