Association of Cryotherapy and Laser Photocoagulation Prophylaxis of Retinal Breaks With Risk of Proliferative Vitreoretinopathy: A TriNetX Analysis

Document Type

Conference Proceeding

Publication Date

6-2025

Publication Title

Investigative Ophthalmology and Visual Science

Abstract

Purpose : To compare the post-treatment risk of proliferative vitreoretinopathy (PVR) following retinal detachment (RD) prophylaxis with cryotherapy versus laser photocoagulation for retinal breaks without RD.

Methods : A retrospective cohort study was conducted using the TriNetX (Cambridge, MA, USA) electronic health record database. Two cohorts were created: one with retinal tear without RD (International Classification of Disease-10 (ICD-10) code H33.3) who received RD prophylaxis with cryotherapy alone (Current Procedural Terminology (CPT) 67141) and another cohort with the same diagnosis who received RD prophylaxis with laser photocoagulation alone (CPT 67145). Both cohorts were evaluated for development of PVR (ICD-10 H35.20). Patients with history of proliferative sickle cell retinopathy, proliferative diabetic retinopathy, and retinopathy of prematurity were excluded. Patients with RD, vitreous hemorrhage, or incisional surgery for RD repair were excluded. Cox proportional hazards model was used to calculate hazard ratios (HR) with 95% confidence intervals (CI). Additional covariates in the model included age, race, hispanic ethnicity, gender, history of tobacco use, and history of uveitis.

Results : A total of 429 patients with retinal break without RD receiving cryotherapy and 19,039 patients with retinal break without RD receiving laser photocoagulation met inclusion criteria for this analysis. Adjusted analysis demonstrated higher risk of PVR in patients with retinal tears that underwent RD prophylaxis with cryotherapy relative to their counterparts that underwent RD prophylaxis with laser photocoagulation (HR 2.603, CI 1.051-6.445, p=0.038).

Conclusions : Previous reports hypothesize a higher risk of PVR with cryotherapy compared to laser photocoagulation for retinal breaks and RD, potentially due to enhanced intravitreal dispersion of retinal pigment epithelial cells. This study may support this hypothesis, finding that in a large electronic health record database, a higher risk of subsequent PVR diagnosis was present in patients that underwent retinal break RD prophylaxis with cryotherapy versus laser photocoagulation alone.

Volume

66

Issue

8

First Page

1913

Comments

Association for Research in Vision and Ophthalmology ARVO Annual Meeting, May 4-8, 2025, Salt Lake City, UT

Last Page

1913

Link to Full Text

Share

COinS