Эндовитреальное хирургическое лечение пролиферативной диабетической ретинопатии через два прокола без использования эндоосветителя

Abstract

Purpose. To describe and evaluate the method of surgical treatment of proliferative diabetic retinopathy (PDR) through two port-punctures without endo-illumination. Material and methods. The study included 10 patients (10 eyes) with complicated cataract and PDR. The mean preoperative best corrected visual acuity (BCVA) was 0.08±0.12. The average age was 57 years: 6 males and 4 females of them. The follow-up period was 5 months. All patients underwent the combined intervention: cataract phacoemulsification with intraocular lens implantation and two-port 25Gauge vitrectomy. One port was used for setting irrigation cannula, the second – for the introduction of various tools. The light of the microscope tube was used instead illumination. Light and color parameters were set up using 3D visualization system allowing using the minimal intensity of the microscope light. Results. In 9 cases out of 10 it was possible to apply the claimed technique, that is, to perform the entire volume of standard manipulations, using two-port punctures. In one case, we switched to a standard three-port vitrectomy, as the patient’s rough proliferative tissue spread to the middle periphery and removal of adhesions, using sclerocompression, could lead to a high risk of iatrogenic damage. Intra- and post-operative complications were not noted in any case. The BCVA was increased 6 months later improved and reached 0.2±0.15. Conclusion. The method of surgical treatment of proliferative diabetic retinopathy through two-port punctures without the use of endo-illumination is a safe and effective surgical treatment of this disease.