Abstract
Purpose.. To optimize the tactics of surgical treatment of persistent fetal vascular network using preoperative multimodal diagnostics and intraoperative control of OCT. Material and methods. 38 patients aged 2 months up to 13 years old with various manifestations of persistent fetal vascular network underwent treatment in Kaluga branch of the S. Fyodorov Eye Microsurgery Federal State Institution at the period from 2015 to 2020. To determine the tactics of treatment for each patient, a set of diagnostic techniques was used as additional research methods to reveal preoperative diagnosis: fluorescence angiography (FAG), duplex ultrasound scanning (DUS), ultrasound biomicroscopy (UBM). Intraoperative optical coherence tomography (OCT) was used for intraoperative control and continuous monitoring of the state of intraocular structures. Results. A complex of diagnostic measures made it possible to develop the most individualized plan for surgical treatment. The UBM data allowed to plan the tactics of surgical treatment of the anterior segment of the eye and intraocular surgery, choose a safe zone during paracentesis and sclerotomy, and as a result avoid iatrogenic damage to the intraocular structures. According to FAG and DUS, performed preoperatively, the site of the fibrovascular dissection was chosen, at about 1.0 mm from the vascularized zone closer to the lens, which made it possible to completely avoid intraoperative hemorrhage. Intraoperative OCT control made it possible monitor in real time the state of the posterior capsule of the lens, fundus structures, and the position of the IOL. Conclusion. Multimodal diagnostics allows to expand indications for surgical treatment of patients with persistent fetal vascular network and perform it at time. Intraoperative OCT control during surgery makes it possible to monitor in real time the state of the posterior capsule of the lens, fundus structures, IOL position, allowing to follow the surgical intervention plan with maximum accuracy. Key words: multimodal diagnostics, surgical treatment, persistent fetal vascular network
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