Introduction

Retinopexy is the most frequently performed vitreo-retinal procedure in eye emergency departments, primarily indicated for horseshoe retinal tears (HST). Prompt treatment significantly reduces the risk of rhegmatogenous retinal detachment (RRD), yet national guidelines remain lacking. Various techniques exist, including slit lamp laser (general ophthalmologists) and indirect laser or cryotherapy (VR specialists)

Purpose

To audit the timing, monitoring, outcomes, and documentation practices of laser retinopexy procedures at Royal Bolton Hospital, and to identify areas for quality improvement, particularly in trainee involvement and VR team coordination.

Methods

A retrospective review of 54 consecutive patients who underwent laser retinopexy between 1st October 2023 and 30th September 2024. Data were extracted from laser logbooks, OpenEyes, Optos, and Forum systems.

Results

The overall RRD rate post-retinopexy was <2%. Most HST cases were treated within 24 hours, and timely VR referrals were consistently made. Trainee involvement was noted to be high with good clinical outcomes. However, documentation of risk factors and procedural details was inconsistent. Monitoring protocols and justification for top-up lasers varied across cases.

Conclusions

The audit demonstrates generally effective and timely management of retinal tears with low complication rates. Improvements are needed in documentation, standardisation of follow-up, and integration of imaging. Establishing a digital logbook in OpenEyes and strengthening VR feedback mechanisms could enhance patient care and training quality

*Learning point

*Required. Relevant to emergency eye care, be succinct no more than 30 words

• Document HRF for every listed case and highlight the priority.

• Double check with 3 mirrors/ and request 4 quadrants optos photos

• 2nd opinion is encouraged if unsure what to do, before listing/performing the retinopexy.

Hashim Butt studied medicine at the University of Liverpool, in the UK. He graduated in 2024 and started working at Bolton Royal Hospital. He has worked in Bolton Royal Hospital as a doctor and has been working towards doing ophthalmology as a career.