Сравнительная оценка эффективности комбинированного метода хирургического лечения регматогенной отслойки сетчатки

Abstract

Purpose. To optimize the technology of surgical treatment of rhegmatogenous retinal detachment by a combination of vitrectomy of the base of the vitreous body in air with 360° peripheral endolaser retinopexy and to evaluate its clinical and functional effectiveness. Material and methods. The control group included 25 patients (25 eyes) with peripheral vitrectomy under the fluid (BSS) with laser restriction of the retinal tear only. The study group included 25 patients (25 eyes) with peripheral vitrectomy under air in combination with 360° laser retinopexy. Groups were compared in terms of visual acuity, duration of retinal detachment, presence of proliferative vitreoretinopathy, macular condition, number of retinal tears, lens condition (phakic/pseudophakic), and recurrent retinal detachment. The frequency of intraoperative iatrogenic retinal tears that occurred during peripheral vitrectomy was also assessed. Results. In the main group, in one case, an atorogenic rupture was detected during surgery. In the control group, there were 3 cases of touching the periphery of the retina with the appearance of a rupture during vitrectomy in the “shave” mode. There are no statistically significant differences in visual acuity after 3-6 months. During the observation period, no retinal detachment recurrence was detected in the main group in any case. Whereas in the control group there were 2 relapses. Conclusions. The advantage of air vitrectomy is a greater view of the periphery of the retina during surgery, which in many cases does not require additional sclerocompression for better visualization. Also residual vitreous body between tissue-air environments is very well identified. 360° endolaser coagulation is a prophylactic procedure to prevent recurrence of retinal detachment. In addition, in our study, we found that peripheral air vitrectomy combined with 360° laser retinopexy had comparable results to fluid vitrectomy in shave mode, with laser limited only around tears. Keywords: rhegmatogenous retinal detachment, vitrectomy, endolaser coagulation