Сравнение кругового экстрасклерального пломбирования и ретинотомии в витреоретинальной хирургии «нижних» рецидивов отслоек сетчатки при выраженной стадии передней пролиферативной витреоретинопатии

Abstract

Purpose. To analyze the results of the treatment of recurrent inferior rhegmatogenous retinal detachments (RRD) complicated by the severe stage anterior proliferative vitreoretinopathy (PVR) in silicone oil (SO) tamponade eyes depending on the volume of surgical intervention: pars plana vitrectomy (PPV) with encircling scleral buckling (SB) versus PPV with retinotomy (RT). Material and methods. 66 patients (66 eyes) with recurrent inferior RRD by the severe stage anterior PVR in silicone oil-filled eyes were included in this retrospective study who were treated in our clinic from 2017 to 2022. 66 eyes were alternatively distributed between 2 groups: PPV with SB (30 eyes), PPV with RT (36 eyes). The outcome measures were anatomical success, which was defined as complete anatomical retinal reattachment and function — best corrected visual acuity (BCVA). Results. 66 patients (66 eyes), 36 men and 30 women, median age 60.0 (50.0; 69.0) years, were included in the study. After surgical treatment, anatomical success was similar in both groups with no statistically significant difference (p = 0.7). When conducting a comparative analysis between the two groups 7 days, 3 and 6 months after surgery, BCVA was statistically significantly higher in the PPV+SB group compared to the PPV+RT group (p = 0.0001). Conclusion. For eyes with recurrent inferior RRD, complicated by an advanced stage of anterior PVR, PPV+SB and PPV+RT allow one to achieve the same anatomical results. According to the functional results, PPV+SB may be a better choice as an alternative to PPV+RT with a statistically significant difference (p = 0.0001). Keywords: recurrence of retinal detachment, scleral buckling, retinotomy, pars plana vitrectomy, silicone tamponade, anterior proliferative vitreoretinopathy