Оптимизация объема предоперационной диагностики у пациентов с персистирующей сосудистой фетальной сетью

Abstract

Purpose. To optimize the scope of preoperative diagnostics in patients with persistent fetal vascular network. Material and methods. The Kaluga branch underwent surgical treatment of 30 patients with various manifestations of persistent fetal vascular network from 2015 to 2020. The age of the patients was from 3 months to 8.5 years. At the stage of preoperative diagnostics, additional research methods was used: fluorescence angiography (FAG), ultrasound color duplex scanning (UCDS), ultrasound biomicroscopy (UBM). Results. A complex of diagnostic measures made it possible to develop the most individualized plan for surgical treatment. In 16 patients, the anterior type of the disease was determined – phacoaspiration with IOL implantation was performed according to the standard technique, if necessary, a “dry vitrectomy” was carried out with the removal of the posterior lens capsule and adjacent parts of the vitreous body. In 11 patients (11 eyes) with a mixed type, phacoaspiration of the lens with IOL implantation and simultaneous 3-port 27g vitrectomy was performed according to the standard technique; tamponade of the vitreous cavity was not carried out. In 10 patients (30%) in the period from 6 months to 1.5 years after the first intervention the reoperation was required. In 27 patients (90%), the transparency of the optical surroundings was restored. Complete retinal attachment was observed in 22 patients (73%). For 3 to 6 months after surgery in 5 patients (17%), traction retinal attachment occurred. In 3 patients (10%), retinal attachment was not achieved despite repeated interventions. Conclusion. A differential approach to each patient based on preoperative multimodal diagnosis made it possible to expand the indications for surgical treatment and achieve satisfactory anatomical and functional results. Keywords: persistent vascular fetal network, complex of preoperative diagnostics, fluorescent angiography, ultrasound color duplex scanning, ultrasound biomicroscopy.