Primary Retinal Detachment

2 Prophylaxis in Fellow Eye of Primary Retinal Detachment 27
ment could (and should) be achieved by systematic “prophylactic”
treatment of various pre-existing asymptomatic retinal lesions.
Two large long-term surveys of reports in the literature, purporting
to substantiate the correctness of this view were published
by Meyer-Schwickerath and Fried in 1980 [3] and by Haut et al. in
1988 [4] all of whom were staunch advocates of this standard of
care and believed that it provided substantial success in achieving
the goal of preventing retinal detachment. Both surveys revealed
that there was a residual risk of retinal detachment, even after
those attempts to prevent it, amounting to 5% in the first report [3]
and 2–5.5% in the second report [4], depending on the modality
used.
Eventually, however, various reports began to appear which
tended to agree in showing that the three underlying assumptions
which formed the basis of the new standard of care were not accurate.
With regard to the first assumption, the bilaterality of retinal
detachment had been considerably overestimated, and instead of
being 20–50%, was in the range of 6–11% [5–13] (Table 2.1).
With regard to the second assumption, it has been reported that
72% of new symptomatic retinal tears occur in retinal areas that
appear clinically normal [14]; and, in a large autopsy study of eyes
Table 2.1. Incidence of bilateral retinal detachment
Author(s) Incidence (%)
Toernquist 1963 [5] 11.2
Edmund 1964 [6] 9.3
Boeke 1966 [7] 6.6
Michaelson et al. 1969 [8] 10.9
Davis et al. 1974 [9] 7.9
Bleckman and Engels 1975 [10] 8.1
Haut and Massin 1975 [11] 11.4
Laatikainen and Harju 1985 [12] 10.0
Toernquist et al. 1987 [13] 11.0