Saratov JOURNAL of Medical and Scientific Research

Clinical and functional results of surgical treatment of regmatogenous retinal detachment by ultrasonic vitrectomy 25G

Year: 2018, volume 14 Issue: №4 Pages: 841-845
Heading: Ophtalmology Article type: Original article
Authors: Aznabaev В.M., Dibaev T.I., Mukhamadeev T.R., Shatunova A.S.
Organization: Bashkir State Medical University of the Russian Health Care, ZAO Optimedservis

Objective: to analyze clinical and functional outcomes of surgical treatment regmatogenic retinal detachment by ultrasound vitrectomy. Material and methods. Clinical and functional results of treatment of 70 patients (70 eyes) with regmatogenous retinal detachment (ROS) who received surgical care in the clinic OPTIMIZED from 2015 to 2018 In the main group (n=33) operations were performed by ultrasound vitrectomy 25G, in the control group (n=37) — by traditional guillotine pneumatic vitrectomy using the tools of the same caliber. During surgery, were analyzed: time of vitrectomy stage (sec), total duration of operation (min), achievement planned anatomical result (%). In the postoperative period (up to 12 months) analyzed: stability of anatomical result (%), maximum corrected visual acuity, intraocular pressure, morphometric criteria retinal conditions (OCT, OCT-angiography), incidence of complicated cataract (%). Results. Average value of vitrectomy stage time in the main group (378.3±125.2 sec) lower than in the control (490.9±175.5 sec), p<0.05. Total duration operations in both groups did not differ, but on average was somewhat shorter in the main group. group (53.6±9.4 and 64.2±23.5 min, respectively). Planned anatomical result in retinal adhesion in all sectors was achieved at the end of the operation in 100% of cases in both groups. No intraoperative complications were recorded in any of the cases. Ultrasonic vitrectomy permits the use of smaller values of the vacuum as on the stage initiation of posterior vitreous detachment (333.3±40.1 mm Hg).St) and at the stage of peripheral vitrectomy (203.2±51.5 mm compared with traditional vitrectomy, where high vacuum was required: 600 mm at the stage of initiation of ZOST, 305,4±66,4 mm Hg.article on stage of peripheral vitrectomy. The anatomical result remained stable in all terms of the postoperative period in the main group in 100% of cases. In control group relapses of retinal detachment were registered in 8.1% of patients and successfully eliminated conducting an audit of the vitreous cavity. In the late postoperative period the most frequent complication was the development of complicated cataracts (27.1 % in the main group, 40.5% in the control). In both groups, by the 12th month of follow-up, high maximum corrected visual acuity (0.5 and higher in 66.6% of patients and in the main 47.3% of patients in the control group). Conclusion. Comparative study conducted the method of ultrasonic vitrectomy in the surgical treatment of rhegmatogenous detachment the retina has shown that this technique is an effective method that provides and stable anatomical and functional result.

1 Avanesova ТА. Rhegmatogenous retinal detachment: current opinion. Ophtalmology 2015; 12 (1): 24-32
2 Libman ES, Shakhova EV. Blindness and disability due to ocular pathology in Russia. Bulletin of Ophtalmology 2006; (1): 35-7
3 Kochmala OB, Zapuskalov IV, Krivosheina Ol, et al. Retinal detachment surgery: state of art. Bulletin of Ophtalmology 2010; (6): 46-9
4 Sodhi A, Leung L. Recent Trends in the Management of Rhegmatogenous Retinal Detachment. Surv Ophthalmol 2008; (53): 50-67
5 Ghazi NG, Green WR. Pathology and pathogenesis of retinal detachment. Eye 2002; (16): 411-21
6 Bayborodov YaV. Prediction of functional outcomes of vitreoretinal operation: PhD abstract. St. Petersburg, 2006; 24 p.
7 Stanga РЕ, Pastor-ldoate S, Zambrano I, Carlin P, McLeod D. Performance analysis of a new hypersonic vitrector system. PLoS ONE 2017; 12 (6): e0178462
8 Rizzo S, Genovesi-Ebert F, Belting О Comparative study between a standard 25-gauge vitrectomy system and a new ultrahigh-speed 25-gauge system with duty cycle control in the treatment of various vitreoretinal diseases. Retina 2011; 31 (10): 2007-13
9 Abulon D. Vitreous flow rates through dual pneumatic cutters: effects of duty cycle and cut rate. Clinical Ophthalmology 2015; 253
10 Charles S, Kalsada J, Wood B. Microsurgery of the vitreous body and retina. 2012; p. 169-80
11 Aznabaev BM, Shirshov MV, Mukhamadeev TR. New algorithms for managing the vitrectomy system. Cataractal and refractional surgery 2013; 13 (2), 37-40
12 Aznabaev BM, Dibaev Tl, Mukhamadeev TR, et al. Ultrasonic vitrectomy: performance evaluation in experimental and clinical conditions. Practical Medicine 2018; 4: 56-60
13 Aznabaev BM, Dibaev Tl, Mukhamadeev TR. Evaluation of the effectivency of ultrasound vitrectomy 25G in the surgical treatment of different vitreoretinal pathology. Modern technology in ophthalmology 2018; 1: 17-21
14 Aznabaev BM, Dibaev Tl, Mukhamadeev TR. Clinical aspects of ultrasound vitrectomy Vestnik of Bashkir State Medical University 2017; 6: 8-17
15 Ophtalmology: clinical recommendation edited by Moshetova LK. Moscow GEOTAR-Media 2009; 352
16 Peene G, Fils J-F, Vanwynsberghe D, et al. The incidence of retinal redetachment after Pars plana vitrectomy with 360° endolaser. Case Reports in Surgery and Invasive Procedures 2017; (1): 8-12
17 Feng H, Adelman RA. Cataract formation following vitreoretinal procedures. Clinical Ophthalmology 2014; 8: 1957-65.

2018_4-2_841-845.pdf263.35 KB

No votes yet