Современные методы профилактики пролиферативной витреоретинопатии при обширных проникающих ранениях склеры

Abstract

Relevance. Currently, there is no single algorithm for the management of patients with extensive penetrating wounds of the sclera, and the frequency of proliferative vitreoretinopathy, leading to adverse outcomes, is very high. Purpose. To present relevant data about prevention of proliferative vitreoretinopathy with extensive penetrating wounds of the sclera, as well as to identify the most effective methods. Material and methods. To complete this review, a literature search was carried out on the databases CyberLeninka, eLIBRARY, PubMed, using the keywords «proliferative vitreoretinopathy», «penetrating wounds of the sclera», «eye injury», «vitrectomy». Preference was given to scientific papers over the past 15 years. Results. There are various approaches in the treatment of severe penetrating wounds. Classical primary microsurgical treatment involves external treatment, suturing of the sclera wound, and delayed optical-reconstructive surgery (including vitrectomy) are performed 1–2 weeks after the acute inflammation reduces. As a rule, in the case of extensive wounds with a whole set of concomitant risk factors, this time is sufficient to trigger pathological proliferation, which aggravates the course of the wound process. This review presents publications proving that the treatment of severe complicated penetrating wounds of the sclera should go beyond the classical treatment and be aimed at early warning and prevention of proliferative vitreoretinopathy. Conclusion. Modern data prove the indisputable advantage of early vitrectomy performed with extensive penetrating scleral and corneoscleral wounds. Vitrectomy in combination with other methods of prevention of proliferative vitreoretinopathy is the most promising direction for the future research. Key words: proliferative vitreoretinopathy, penetrating wounds of the sclera, eye injury, vitrectomy