Photocoagulation and diathermy in the treatment of proliferative sickle retinopathy

Abstract

The O'Malley Log II portable photocoagulator was used to treat the worse eye of 36 patients with proliferative sickle cell retinopathy flat on the retinal surface. The technique involved direct coagulation of the feeder arterioles before treatment of the new vessels themselves. The photocoagulator was most successful in treating the lesions and 131 of 137 retinitis proliferans (RP) lesions were occluded. In only one RP lesion did the photocoagulator have insufficient power to occlude the lesion. Vitreous haemorrhage occurred in only one patient, and small round localized retinal haemorrhages in five. The Manchester portable diathermy machine successfully occluded all 29 raised RP lesions and 50 feeder arterioles in 13 patients. Anterior segment ischaemia occurred in only one patient who had advanced traction retinopathy involving 360° of arc of the retinal circumference before treatment. No recurrence of retinopathy over a 2 yr follow up period was seen in seven patients, and in the remainder there was no recurrence in the 2 mth after treatment.