Primary prevention
The prevention of non-rhegmatogenous retinal detachment depends on the aetiology and may include controlling diabetes or treating any choroidal neovascularisation (e.g., with anti-vascular endothelial growth factor medication).
Observation alone may suffice for patients with sub-clinical detachments (asymptomatic, small, and non-progressive lesions).[17] Consider prophylactic therapy in all other cases based on the condition and history of both eyes.
Secondary prevention
Because many of the risk factors for RD may be present in the fellow eye, prophylactic treatment should be considered, and self-monitoring is advisable.
It is reasonable to treat a normal fellow eye prophylactically when the other eye has a rhegmatogenous RD, especially in the presence of additional risk factors such as planned cataract surgery, high myopia, or an injury-prone lifestyle. In these cases, apply a 360° rather than a focal treatment for the best outcomes.[74]
Certain conditions and diseases (e.g., diabetes) can cause bilateral non-rhegmatogenous RD, even if the RD does not present simultaneously or the eyes differ markedly in RD severity. Proper treatment of the underlying cause can prevent RD in the fellow eye.
In patients with rhegmatogenous RD treated by vitrectomy with silicone oil, application of 360° laser treatment (intra- or post-operatively) reduces the incidence of RD after silicone oil removal.[75] Laser retinopexy is preferred to cryopexy.
For eyes where the fellow eye has sustained an RD due to a giant tear, silicone oil or perfluoropropane gas have similar effectiveness, while sulfur hexafluoride gas is less effective.[76]
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