Saratov JOURNAL of Medical and Scientific Research

ultrasonic 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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The analysis of microcirculation parameters of the macular area after ultrasonic vitrectomy using optical coherence tomography-angiography

Year: 2018, volume 14 Issue: №4 Pages: 856-862
Heading: Ophtalmology Article type: Original article
Authors: Aznabaev В.М., Dibaev T.l., Ismagilov T.I..
Organization: Saratov State Medical University, ZAO Optimedservis
Summary:

Purpose: to analyze the parameters of the microcirculation of the macular area in patients operated on by the method of ultrasound vitrectomy 25G for idiopathic through macular opening (IMO) and epiretinal fibrosis (ERF). Material and Methods. ОСТ angiograms of 35 patients operated on by ultrasound vitrectomy for idiopathic through macular opening (IMO) and epiretinal fibrosis (ERF) before and for 3 months after surgery were analyzed. The following parameters of microcirculation of the retina were investigated: the area of the foveal avascularzone (FAZ), the density of the foveal vessels in the ring 300 urn around the FAZ, the density of the vessels in the superficial and deep capillary networks of the retina. Results. The FAZ area with IMO decreased within 3 months, while with ERF an increase in this parameter was recorded (p<0.05). In the superficial capillary network in both pathologies there was a decrease in the density of the vascular pattern (p<0.05), in IMH there was a tendency to recovery to the pre-op values. The deep capillary network was characterized by decrease of vascular pattern density to 1 month with following increase to 3 month (p<0.05). Conclusion. Features of the dynamics of the parameters of the microcirculation of the macular area in different periods of the postoperative period largely depend on the nature of the pathology, the stress response of the tissue to the operative traumaand the degree of recovery of the vascular pattern of the retinal neuroepithelium in the superficial and deep capillar networks.

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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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