Saratov JOURNAL of Medical and Scientific Research

Republican Clinical Ophthalmologic Hospital, Сhuvashia

The use of autologous conditioned plasma in the surgery of cicatricial stage of choroidal neovascular membrane

Year: 2020, volume 16 Issue: №2 Pages: 569-572
Heading: Ophtalmology Article type: Short message
Authors: Arsyutov D.G.
Organization: Republican Clinical Ophthalmologic Hospital, Сhuvashia
Summary:

The purpose of the study is to estimate the effectiveness of the cicatricial stage of choroidal neovascular membrane surgery with retina fixation after retinotomy of paracentral areas with the use of autologous conditioned platelet rich plasma (ACP), without performing endolaser photocoagulation and silicone oil tamponade. Material and Methods. The surgery technique involved performing the 25,27-gauge vitrectomy, removing the posterior hyaloid membrane, the inner limiting membrane in the presence of an epiretinal membrane, paracentral retinotomy, removing the choroidal neovascular membrane during retinotomy, pneumoretinopexy, ACP instillation in the retinotomy area in 2-3 layers without endolaser photocoagulation and silicone oil tamponade. Seamless closure of sclero and conjunctivotomy with a layer of autologous conditioned plasma. 17 patients with visual acuity from 0.02 to 0.08 were treated. Results. A full retinal reattachment and closure of the retinotomy opening in the late postoperative period was noted in all patients. Not a single recurrent retinal detachment was recorded. Complete closure of sclero and conjunctivotomy without the use of additional suture fixation in all cases was achieved. Visual acuity after removal of the cicatricial choroidal membrane in the long-term period was 0.03-0.2. Conclusion. Surgical treatment of the cicatricial stage of choroidal neovascular membranes using autologous conditioned plasma to close the retinotomy defect after removal of cicatricial choroidal neovascular membrane without endolaser coagulation of the retina and silicone tamponade, followed by seamless blocking of the sclero and conjunctivotomy with autologous conditioned plasma is a modern technique that allows to achieve high anatomical and functional results, minimizing the risk of postoperative complications.

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Use of platelet rich plasma, including autologous conditioned plasma, in the surgery of perforating eye injuries

Year: 2020, volume 16 Issue: №1 Pages: 207-210
Heading: Ophtalmology Article type: Original article
Authors: Arsyutov D.G.
Organization: Republican Clinical Ophthalmologic Hospital, Сhuvashia
Summary:

The purpose of the study is to evaluate the effectiveness of surgical treatment of double perforating eye injury of different localization and length with the damage to the retina, the vascular layer and the sclera of the posterior eye segment, using platelet rich plasma, including autologous conditioned plasma, without additional scleroplasty and endolaser photocoagulation. Material and Methods. The surgery technique involves carrying out 25+ gauge vitrec-tomy, removing the foreign body, posterior hyaloid membrane, in case of central and paracentral retinal detachment it involved removing the inner limiting membrane. Pneumoretinopexy was performed. After maximum removal of liquid between the air bubble and the tear we carried out instillation of platelet rich plasma or autologous conditioned plasma in 2-3 layers, involving retina around the tear, until full repair of the scleral-choroidal-retinal tear without laser coagulation, additional scleral suturing and external scleroplasty. The study involved nine patients with visual acuity from the incorrect visual projection to 0.02. Results. In the early postoperative period the retina was reattached in all the patients, the scleral-choroidal-retinal tear was blocked. In the long-term (1-12 months) period, no recurrent depressurization of the eyeball wall and retinal detachments were recorded. In two patients the healing was accompanied by the rough chorioretinal scar formation and retinal duplicate in the scarring area. The visual acuity of the operated patients was 0.03-0.4. Conclusion. Surgical treatment of the double perforating eye injury, accompanied by retinal detachment, with the use of platelet rich plasma and autologous conditioned plasma without laser coagulation of the retina, scleral suturing of the posterior eye segment and additional scleroplasty is a method that allows to achieve total scleral and chorioretinal repair and get a good anatomical and functional result.

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Preliminary results of modifed cryogenic scleroplasty

Summary:

Purpose: to assess preliminary results of modifed cryogenic scleroplasty efcacy in patients with progressing myopia. Material and Methods. Modifed cryogenic scleroplasty was developed by us in order to decrease the risk of deformation, torsion and displacement of scleroplastic material during its implantation. 38 children (72 eyes) aged 7–17 years with diagnosis of acquired progressing medium and high myopia with documented annual gradient of progressing more than 1 D were operated. 35 children (64 eyes) were the control group. They underwent standard scleroplasty by Pivovarov — Pristavko method. Results. No complications and adverse reactions to the transplantation material were observed during modifed cryogenic scleroplasty. Due to exposition in liquid nitrogen solution transplant keeps form and is not deformed during immersion and its partial location under the muscle. Stabilizing efect of the studied method (according to clinical refraction and axial length) is comparable to other types of scleroplasty. Conclusion. The developed technology of surgical treatment of progressing myopia is characterized by technological simplicity, convenience in material implantation, exclusion of transplant deformation and torsion on episclera surface, high stabilizing efect during the frst year after the surgery.

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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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