Comparative Analysis of Visual and Anatomical Outcomes of Drainage Retinotomy: LASER Alone Versus LASER with Amniotic Membrane Graft

Background: Rhegmatogenous retinal detachment (RRD) is a vision-threatening condition that requires timely surgical intervention to prevent permanent visual loss. Despite substantial advances in modern vitreoretinal surgery, the presence of proliferative vitreoretinopathy (PVR) continues to complicate management, often limiting anatomical success and functional recovery. Often, these cases need a drainage retinotomy to ease the tension and help reattach the retina. Conventional laser photocoagulation remains the standard method for sealing retinal breaks, but can induce thermal damage and postoperative scarring, limiting functional recovery. The use of human amniotic membrane graft (AMG) has recently attracted attention due to its anti-inflammatory, anti-fibrotic and regenerative properties that promote retinal healing and reduce fibrosis. International evidence supports the potential benefits of AMG in complex retinal detachment repair; However, local data is limited. This study was designed to compare the anatomic and visual outcomes of drainage retinotomy treated with laser alone versus laser combined with AMG in patients with RRD complicated by PVR. Objective: To report the anatomical and visual outcomes in RRD patients worsened by PVR, undergoing Retinotomy with LASER only vs patients undergoing Retinotomy with Amniotic Membrane Grafts and LASER. Method: A prospective cohort study was conducted at the department of Ophthalmology, Lahore General Hospital over a period of twelve months from 1st feburary2023 to 1st February 2024. A total of 20 patients, 14 males (70%) and 6 females (30%) were included in this study. The patients were diagnosed case of rhegmatogenous retinal detachment complicated by PVR. We divided the patients into two groups; A and B. Group A underwent retinectomy with LASER only and Group B underwent Retinectomy with Amniotic Membrane Grafts and LASER. The patients were followed up for 3 months after surgery. Results: Surgical outcome was measured in terms of achieving complete anatomical closure and improvement of visual acuity. In our study 100% of the patients achieved complete anatomical closure whereas visual acuity improvement was seen more in the patients treated with AMG than those treated with laser alone. Conclusion: Visual and anatomical outcomes were better in patients that underwent AMG with LASER for the treatment of retinotomy as compared to those who underwent LASER only.