Saratov JOURNAL of Medical and Scientific Research

vitrectomy

Thermal imaging characteristics of ultrasonic and pneumatic guillotine 25 gauge vitrectors

Year: 2018, volume 14 Issue: №4 Pages: 916-919
Heading: Ophtalmology Article type: Original article
Authors: Aznabaev В.М., Dibaev T.N., Mukhamadeev T.R., Vafiev A.S., Shavaliev I.Kh.
Organization: Bashkir State Medical University of the Russian Health Care, ZAO Optimedservis
Summary:

Purpose: to analyze thermal characteristics of ultrasonic and pneumatic guillotine 25G vitrectors in the experiment. Materials and Methods. In vitro studies were performed using Testo 882 thermal imager under various conditions for a more complete assessment of thermal characteristics of 25G ultrasonic vitrector and 25G pneumatic guillotine vitrector. First experiment was carried out in normal saline solution of room temperature, second experiment was performed in air medium. Results. It was found that during operation of ultrasonic and pneumatic guillotine vitrectors, the temperature threshold of 45°C, which is critical for thermal damage to retinal tissue, was not reached in all experiments. Under severe conditions (working in the air medium without cooling of vitrector tip), different localization of the heating zone in ultrasonic (at proximal part of the needle) and pneumatic (at distal part, near the port) vitrectors was detected. Conclusion. In experimental conditions, the thermal safety of ultrasonic and pneumatic guillotine vitrectors of caliber 25G has been proved by the method of infrared thermal imaging.

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Surgical treatment of regmatogenous retinal detachment complicated by macular hole using platelet-rich blood plasma and local staining

Year: 2018, volume 14 Issue: №4 Pages: 867-870
Heading: Ophtalmology Article type: Original article
Authors: Zaharov V.D., Shkvorchenko D.O., Krupina E.A., Kakunina S.A., Norman K.S., Khurdaeva A.G., Yukhananova A.V.
Organization: The S. Fyodorov Eye Microsurgery Federal State Institution
Summary:

Purpose: to study the effectiveness of surgical treatment of regmatogenous retinal detachment (ROS) complicated by macular hole (MH) using platelet-rich blood plasma (PRP). Material and Methods. The study included 27 patients (27 eyes) with a diagnosis of ROS complicated by MH. In each case, the technique was used, namely, that after performing vitrectomy, a perfluororganic compound (PFOS) was injected into the hole area with a diameter of 2-3 diameter of the disk, to prevent penetration of dye under the retina, stained and removed internal limiting membrane (ILM). After serial PFOS/air replacement at the gap introduced PRP. The operation was completed with the introduction of silicone oil (CM). CM was removed from the vitreous cavity after 2 months. The follow-up period is 12 months. Results. In all cases, it was possible to achieve the adhesion of the retina and block Mr. During the observation period visual acuity increased to 0.1-0.9. Conclusion. According to the evaluation of the results, surgical treatment of regmatogenous retinal detachment complicated by MH using PRP is an effective method of treatment.

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Surgical treatment of regmatogenous retinal detachment complicated by macular hole using platelet-rich blood plasma and local staining

Year: 2018, volume 14 Issue: №4 Pages: 867-870
Heading: Ophtalmology Article type: Original article
Authors: Zaharov V.D., Shkvorchenko D.O., Krupina E.A., Kakunina S.A., Norman K.S., Khurdaeva A.G., Yukhananova A.V.
Organization: The S. Fyodorov Eye Microsurgery Federal State Institution
Summary:

Purpose: to study the effectiveness of surgical treatment of regmatogenous retinal detachment (ROS) complicated by macular hole (MH) using platelet-rich blood plasma (PRP). Material and Methods. The study included 27 patients (27 eyes) with a diagnosis of ROS complicated by MH. In each case, the technique was used, namely, that after performing vitrectomy, a perfluororganic compound (PFOS) was injected into the hole area with a diameter of 2-3 diameter of the disk, to prevent penetration of dye under the retina, stained and removed internal limiting membrane (ILM). After serial PFOS/air replacement at the gap introduced PRP. The operation was completed with the introduction of silicone oil (CM). CM was removed from the vitreous cavity after 2 months. The follow-up period is 12 months. Results. In all cases, it was possible to achieve the adhesion of the retina and block Mr. During the observation period visual acuity increased to 0.1-0.9. Conclusion. According to the evaluation of the results, surgical treatment of regmatogenous retinal detachment complicated by MH using PRP is an effective method of treatment.

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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
Summary:

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 Hg.art.) compared with traditional vitrectomy, where high vacuum was required: 600 mm Hg.art. 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.

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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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