Saratov JOURNAL of Medical and Scientific Research

Fayzrakhmanov R.R.

State Budgetary Institution "Ufa eye research institute of the Academy of Sciences of the Republic of Bashkortostan", the head of the vitreoretinal and laser surgery department, Doctor of Medical Science

Dynamics of changes of microperimetry parameters of retina by closure of macular hole with preservation of internal limiting membrane

Year: 2020, volume 16 Issue: №2 Pages: 463-467
Heading: Ophtalmology Article type: Original article
Authors: Pavlovsky О.А., Fayzrakhmanov R.R., Larina Е.А., Sukhanova A.V.
Organization: National Medical and Surgical Center n. a. N. I. Pirogov
Summary:

Objective: To evaluate the medical effectiveness of the macular hole closure (MH) technique, which is based on the limiting of the internal limiting membrane (ILM) peeling. Material and Methods: The results of surgical treatment of 80 patients (80 eyes) diagnosed with MH were analyzed. Patients are divided into two groups: group 1-patients who had a standard peeling; group 2-patients who were operated on using the original method with partial peeling of the macular area. All patients underwent visometry, biomicroscopy, ophthalmoscopy, and OCT-examination. Results: By the 30th day after surgical treatment, a statistically significant excess of light sensitivity parameters was detected in the nasal part of the pattern used: the upper-nasal and lower-nasal quadrants, where peeling was not performed (p=0.032) and (p=0.034), respectively. In the 1st observation group, the recovery of the fixation point was observed during the early and late operating period and at 12 months was 58.3% (p=0.041). In group 2 patients, by the time of 1 month after surgery, the recovery of the fixation point occurred in 88.7%. Conclusion: When conducting the method of limited peeling, the ILM is preserved, which reduces the risk of intraoperative damage to the retina layers. A higher functional result was obtained in comparison with the group where the standard method was used.

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Combined approach to the surgical treatment of patients with prolifera-tive stage of diabetic retinopathy

Year: 2017, volume 13 Issue: №2 Pages: 338-345
Heading: Ophtalmology Article type: Original article
Authors: Bikbov M.M., Fayzrakhmanov R.R., Kalanov M.R.
Organization: State Budgetary Institution "Ufa eye research institute of the Academy of Sciences of the Republic of Bashkortostan"
Summary:

Purpose: to evaluate the effectiveness of combined surgical treatment in patients with proliferative stage of diabetic retinopathy. Material and Methods. 52 patients with advanced stage of proliferative diabetic retinopathy who were divided into 2 groups were examined. Group 1 consisted of 30 patients with a preliminary intravitreal injection of ranibi-zumab, followed by vitrectomy In group 2, 22 patients underwent vitrectomy without anti-VEGF therapy. Visual acuity in the 1st group before treatment was 0.04±0.02, in the second 0.05±0.03. The thickness of the retina in the foveolar zone of the 1st group was 358±34 urn, in the second 378±44 urn. Height of the complex "PHM with fibro-glial proliferation — retina" 670±38 and 710±30, respectively. Results. The visual acuity after treatment increased 4.2 times (group 1), in comparison with the results of the second group by 2.5 times. In patients of the 1st group intraoperative hemor-rhagic manifestations were observed in 36.6% of cases, in the 2nd group in all patients. An increase in the height of the complex "PHM with fibro-glial proliferation — retina" was noted in 83.3% in patients of the 1st group one month after the injection. The height of the complex increased on average to 153±25 urn, which in 76.6% increased the traction effect on the retina. The neovascularization regression occurred 4-8 days after ranibizumab injection in group 1 patients. The retinal thickness of the central zone 10 months after vitrectomy decreased to 220±10 urn in the 1st group and to 273±14 urn in the 2nd group, respectively. Conclusion. The use of inhibitors of angiogenesis, in particular ranibizumab, as a preoperative preparation of patients with proliferative stage of diabetic retinopathy reduces the risk of intra- and postoperative hemorrhagic complications, which facilitates the implementation of vitrectomy, avoids additional vitreo-retinal interventions, in connection with which a positive functional result remains.

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