Saratov JOURNAL of Medical and Scientific Research

retinal detachment

Evaluation of the functional efect of surgical treatment of rhegmatogenous detachment in the late postoperative period

Year: 2019, volume 15 Issue: №2 Pages: 470-473
Heading: Ophtalmology Article type: Original article
Authors: Zaika V.A., Yakimov A.P., Yuryeva T.N.
Organization: The S. Fyodorov Eye Microsurgery Federal State Institution
Summary:

Purpose: to identify the key factors determining the functional outcome of surgical treatment of rhegmatogenous retinal detachment. Material and Methods. The study group included 39 patients operated for rhegmatogenous retinal detachment, which 6 months after surgery were divided into 2 groups depending on visual acuity obtained. All patients underwent standard ophthalmologic examination and color computed perimetry, electrophysiological studies, electro-retinography and registration of visual evoked potentials, optical coherent tomography, color Doppler mapping of posterior pole vessels. Results. 6 months after the surgical treatment of retinal detachment in the 1st group, best corrected monocular visual acuity increased by 4 times in comparison with the 2nd group. When analyzing color-opponent perim-etry results in patients of the frst group, a threefold improvement in medium sensitivity and reliability factor indices for both red and blue stimuli was detected in comparison with the 2nd group. Patients in the 2nd group showed an increase in the phosphene index. In patients of this group in late postoperative period there was an increase in peripheral resistance of vascular wall in both arterial and venous parts of the blood fow, which was probably one of important reasons for non- recovery of vision in patients of this group. Conclusion. Full restoration of regional blood fow and receptor channels of organ of vision, as well as restoration of local and general electrical sensitivity of retina and visual pathway conductivity, is a necessary component of successful restoration of visual functions.

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The use of autologous conditioned platelet rich plasma in the surgery of rhegmatogenous retinal detachment with central, paracentral and peripheral tears

Year: 2019, volume 15 Issue: №2 Pages: 422-425
Heading: Ophtalmology Article type: Original article
Authors: Arsyutov D.G.
Organization: Republican Clinical Ophthalmologic Hospital, Сhuvashia
Summary:

Purpose: to evaluate the efectiveness of surgical treatment of rhegmatogenous retinal detachment with central, paracentral and peripheral tears using autologous conditioned platelet rich plasma (ACP), without endolaser photoco- agulation and silicone oil tamponade. Material and Methods. The operative technique consists of carrying out 25 & 27 Ga vitrectomy, removing the posterior hyaloid membrane, the inner limiting membrane in the presence of a macular hole, pneumoretinopexy. ACP, devoid of leukocytes and containing 1.5–3 times more platelets that found in whole blood is then instilled into the central, paracentral and / or peripheral retinal tears in 2–3 layers including retina around the tear. 59 patients with visual acuity from the correct visual projection to 0.9 were treated. Results. The retina was reattached in 96.6 % of patients and the retinal tears were blocked; two patients with multiple peripheral tears underwent operation. Over a 1–12 months follow up period, 4 recurrent retinal detachments were recorded, which also required repeat surgery. In 93.2 % of patients complete retinal reattachment and blocking of the retinal defect was achieved. The visual acuity of the operated patients was 0.03–0.9. Conclusion. 25 & 27 Ga vitrectomy of retinal detachment with central, paracentral and peripheral tears and blocking of retinal defects with ACP without endolaser photocoagulation of the retina and silicone tamponade is a method that enables total retinal reattachment and better functioning of the operated eye to be achieved in most cases.

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Intraoperative OCT-assisted vitreoretinal surgery

Year: 2018, volume 14 Issue: №4 Pages: 849-855
Heading: Ophtalmology Article type: Original article
Authors: Aznabaev В.М., Dibaev T.l., Husniyarova A.R.
Organization: Bashkir State Medical University of the Russian Health Care
Summary:

Purpose: comparative analysis of clinical and functional results of surgery of vitreomacular interface and rheg-matogenous retinal detachment with the use of intraoperative optical coherence tomography. Material and Methods. Clinical and morphofunctional data were analyzed in 102 patients with epiretinal fibrosis (ERF), idiopathic macular hole (IMH), and rhegmatogenous retinal detachment (RRD), who were divided into 2 groups. In the main group (n=52), the surgery was performed using intraoperative ОСТ control, in the control group without it. In the main group intraoperative control was performed at 4 stages of the surgery: before vitrectomy, after vitrectomy, during the main stage of the surgery and after completion of endotamponade of the vitreous cavity. During surgery for macular disorders intraoperative complications were assessed, in RRD the intraoperative screening for the detection of undiagnosed pathological changes was performed. In the postoperative period, clinical and functional results were assessed in up to 6 months. Results. The use of intraoperative ОСТ control allowed to reduce the frequency of intraoperative complications, such as capillary retinal bleeding (19.2% in the control group, 11.5% in the main group) and pinching of the inner retinal layers (not observed in the main group, in the control group its incidence was 23.1%) in macular surgery. Intraoperative ОСТ made it possible to better identify concomitant retinal pathology (secondary epiretinal membranes in the main group were found during the surgery in 11.5% of cases, in the control group in 4.2%, while in the postoperative period in 12.5%). In complicated cases of RDD, tomographic control allows to identify microstructural features of the posterior pole of the eye, which are important in achieving stability of the anatomical result, such as retinal defects over staphyloma of the posterior pole in high myopia cases. Conclusion. Intraoperative OCT-assisted vitreoretinal surgery reduces the rate of intraoperative complications during macular surgery and gives valuable diagnostic information in complicated retinal detachment cases.

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