Should I treat Lattice Degeneration prophylactically w/laser?

[GuyR]

Dear Doctor,

Last month I had a retinal tear out of the blue while visiting my parents back east. I had it immediately treated the next day with laser surgery, but there is still some sub-retinal fluid trapped under the welds. Now that I am back home, I have been monitoring it with a retina specialist here in town...opting for major surgery only if a RD develops. I was diagnosed with lattice degeneration in BOTH eyes.

So far, the right eye lattice has no holes or retinal tears. The retina specialist back east recommended that I look into getting some laser treatments in my right eye when I returned home, for prevention of future tears/RD.

Questions:
1.) Should I go forward with this preventative laser surgery, or just monitor the right eye regularly?

My fear is that if i sit and wait, and watch, my right eye will develop a tear(s) w/vitreous hemorrhages, causing more floaters and risk of RD as well. I still have 20/20 vision in both eyes, but the floaters in the left eye are a nuisance. I do not want the same thing to happen in my right eye.

Besides consulting with my specialist, the research I am doing on line indicates a mixed input which is very confusing to me. One source says that prophylactic treatment of lattice does not necessarily prevent future tears, etc., while another source will recommend the treatment to strengthen the lattice.

I have also read that new laser welds for lattice creates scarring on the retina, thereby giving the vitreous more to "tug" on for a more severe future retina tear!

2.) My specialist said that the lattice areas in my right eye were in the 1 + 9 o'clock position, so preventative treatment could help. Does the o'clock position of the tears, and lattice locations indicate more risk of tears & RD? I ask so many questions during my follow up exams, and I leave with even more questions!

I really appreciate your reply and input.
Thank you kindly for your time!
Guy

[akshy]

I have lattice degeneration with hole in both eye,just i came to know this just before one month then doctors told me to go through laser treatment,but i want to get some knowledge from some other doctor.So i met to another doctor and after test doctor told me now the laser treatment is not necessary
.But when you will see flash or floaters(like threads) then come we will do the laser treatment but just  from past one weak  now black thread,some black spot is moving in front of my eye  in right eye.Again i went to the same doctor but doctor told me that no  laser treatment needed for now,just go through regular checkup in 6 month.Now i am confused what to do i should wait for treatment or do it immediately.please reply thanks in advance...

[GuyR]

Doctor Oyakawa,

I appreciate your response regarding my questions concerning prophylactic treatment for lattice degeneration. Your input is worth much consideration.

So do you feel if I have some lattice in the right eye, it might be risky to apply preventative laser surgery? Would it be better to just monitor the eye for any future changes?

I called the retina specialist in NY today and spoke very briefly. He was the one that performed the original emergency laser repair in my left eye for the retinal tear. He said he recommended laser in the right eye since I had lattice in both eyes.

But now, I am afraid to take the chance, and leave my right eye alone, but monitor it regularly. I appreciate any more advice.

Thank you kindly for your expertise time!
Sincerely - Guy

[Ray T Oyakawa, MD]

Unfortunately,  tears can occur in normal looking retina away from the area of lattice.  The main complication of laser treatment is macular pucker which can occur in about 2 to 3 %.  The retinal community is divided on this issue.  Also, there is an incentive for the doctor to treat.

This situations is face by ophthalmologist and it is even hard to them to decide.  We all want to do something.  However, something has complications.

A certain location of lattice does not suggest treatment is more beneficial.

Dr.  O.