Комбинированная лазерная хирургия клапанных разрывов сетчатки в профилактике гемофтальма

Abstract

Purpose . To estimate clinical results of combined laser technology of vitreous hemorrhages due to retinal vessels avulsion in horseshoe tears prevention. Material and methods . The surgery was performed in 24 eyes of 22 patients with the presence of the blood vessel in the zone of the retinal horseshoe tear. The combined laser technology included the horseshoe tear barrier laser photocoagulation prior to the blood vessel laser photocoagulation with immediate Nd:YAG-laser vessel dissection. All patients were examined by the standard ophthalmoscopy and novel diagnostic modalities, such as ultrasound, digital retinal imaging and scanning laser imaging of the fundus periphery at the baseline, 1, 3and 12-month follow-up. Results. The complete blood vessel dissection has been achieved in all of 24 eyes. The bridge-vessel laser dissection without hemorrhages was in 15 of 19 eyes. Slight hemorrhages in 4 cases during laser surgery were observed. In all 5 eyes with the adjacent vessel the bloodless dissection was also achieved without intraoperative complications. There was no occurrence of bleeding from the dissected vessels for the entire followup period. Conclusion. The combined laser technology of the vitreous hemorrhages prevention has demonstrated positive clinical results in patients with bridging retinal vessels. In case of the tear progression and the risk of adjacent vessel avulsion repeated combined laser dissection can be performed.