Результаты хирургического лечения витреоретинальной патологии у пациентов с сосудистыми бельмами IV категории после кератопротезирования

Abstract

P urpose . To analyze the results of the surgical treatment of vitreoretinal pathology at patients with vascular leukoma IV of the category after keratoprosthetics. Materia l and methods. A retrospective analysis of the results of the surgical treatment of posterior segment of eye of 17 patients (17 eyes) with vascular leukoma IV of the category was conducted. According to the ultrasonic-scanning data, in the postoperative period up to two years, a funnel total retinal detachment from 2 patients, partial or total hemofthalmus in 5 eyes, destruction vitreous humour of varying degrees was expressed in seven eyes, preretinal fibrosis in 3 eyes. In all cases, vitreoretinal intervention was carried out using microinvasive subtotal vitrectomy system. Clinical evaluation of the effectiveness of treatment was carried out on 3-4 days of the post-operative and after 3-4 years of observation. R esults . There were no complications during the surgical intervention. For 3-4 days in the postoperative period, all patients were found to have a positive anatomical result. In 11 patients showed improvement of visual acuity ranging from light perception to hand motion of the face, and vision 6 patients remained unchanged. At the maximum period of postoperative observation (up to 4 years) in 2 cases the recurrence of retinal detachment. In case of recurrence of retinal detachment in the background of the protrusion of keratoprosthetics surgery was not performed. Anatomical results were satisfactory in 82.3% of cases, visual acuity ranged from 0.01 to 0.3 at 52.9%. Conclusion . Surgical treatment of vitreoretinal pathology at patients after keratoprosthetics is difficult and requires non-standard approach to determine the tactics of treatment and achieve satisfactory functional and anatomical results. However, the microinvasive subtotal vitrectomy of this group of patients is the only effective method for restoring visual functions.