Surgical Treatment Of Retinal Detachment Research Articles

Investigation of Differences in the Techniques of Experimental Vitreo-retinal Operations on Laboratory Animals

The continuous development of vitreoretinal surgery makes it possible to provide high-tech care to patients with retinal detachment while minimizing intraand postoperative complications. However, their percentage still remains significantly high. This pushes modern ophthalmological science to new research and search for solutions to existing problems. In this task, laboratory animals, on which the latest advances in medicine have been tested for more than 100 years, help like no one else. Unfortunately, the high cost of experiments often repels and/or pushes them back indefinitely. Given the clinical significance of experimental studies of surgical treatment of retinal detachment, as part of the study of the new hydrogel preparation Vitreolon, an analysis was made of methods for removing the vitreous body and their effect on the result of surgical intervention.Purpose: analysis of differences in vitreous removal techniques in laboratory rabbits.Material and methods. The experiment involved 6 rabbits (12 eyes) with induced retinal detachment. In 6 eyes, vitrectomy was performed using a vitreotome, in the others, using a syringe (21G). Subsequently, tamponade of the vitreal cavity was performed with the new hydrogel preparation “Vitreolon”. Ophthalmological examinations were performed on the 1st day, 1st and 2nd week, 1st and 3rd months after surgery. After that, the eyes were enucleated to conduct a morphological study of macropreparations and histological sections of the eyes.Results. According to the results of ophthalmological and laboratory studies, there was no statistically significant difference between the techniques for removing the vitreous body. One rabbit had hypertension and cataracts, which indicates its individual response to surgery. There were no complications that could lead to early termination of the experiment.

Changes of the morpho-functional parameters of the retina of patients after surgical treatment of rhegmatogenous retinal detachment complicated by macular hole in the early postoperative period

Objective: to realize the effectiveness of surgical treatment of patients with retinal detachment and macular hole PVR C, depending on the method of closing the macular hole. Material and methods. The data of 20 patients (20 eyes) with a diagnosis of retinal detachment with macular hole PVR С were studied. Patients of the 1st group (10 patients, 10 eyes) underwent surgical treatment with closure of the macular hole with an inverted flap of the inner limiting membrane. Patients of the 2nd group (10 patients, 10 eyes) did not undergo closure of the macular hole during the first stage of surgical treatment. Results. In the 1st group, it was possible to achieve closure of the macular hole in 80% of cases. In the 2nd group, a day after the operation, there was a significant decrease in the diameter to 263±46 urn. When re-examined a month later, in 80% of cases, the macular hole was closed. When studying the results of micro-perimetry one day after the operation, positive dynamics was noted. While after a month of observation, the indicators of patients in the second group were significantly higher. Conclusion. The method of surgical treatment of retinal detachment with macular hole showed greater efficiency in refusing to perform membranopiling; in patients of this group, higher functional results were achieved. During the observation period, cases of a decrease in the diameter of an intact macular hole and its complete closure under the action of silicone tamponade were recorded. If necessary, membrane peeling can be delayed during a second silicone oil removal operation.

Surgical treatment of retinal detachment complicated by a macular hole

Retinal detachment with a macular hole is a severe pathology leading to vision loss and disability of the patient. It is most frequently observed in myopes and causes severe damage of functional parameters of the retina. The pathogenesis of the disease is associated with tangential tractions of the inner limiting membrane and the posterior layers of the vitreous that affect the retina of the myopic eye. Modern ophthalmology uses a variety of approaches to the surgical treatment of the pathology. The final functional result primarily depends on how successful the macular hole closure and retinal reattachment are. To achieve this success, various techniques of subretinal fluid drainage can be used. The present literature review was conducted using the Pubmed search engine. We analyzed the articles published from 2000 to 2021. The analysis of research results showed the advantage of the peripheral method of drainage using a perfluoroorganic compound. This technique is relevant both in cases of the peripheral retinal tear and in subretinal fluid aspiration through the retinotomy. The peripheral method of drainage using a perfluoroorganic compound ensures a better functional outcome, which, in case of retinal detachment with a macular hole, mainly depends on the safety of the neuroreceptors of the central zone and the closure of the macular hole.

Клинический случай успешного лечения отслойки сетчатки методом пневморетинопексии у пациента, направленного на витрэктомию

Introduction. Pneumoretinopexy is a minimally invasive intervention that allows to provide both anatomical and functional results in cases of uncomplicated retinal detachment. Perpose. To demonstrate the result of surgical treatment of regmatogenic retinal detachment using pneumoretinopexy instead of vitroctomy. Material and methods. Patient A., 52 years old, was urgently admitted to the vitreoretinal department of Moscow City Ophthalmological Center with the diagnosis: Widespread regmatogenic retinal detachment without macular area capture, proliferative vitreoretinopathy state A. Partial vitreous hemorrhage. Phacosclerosis. A pneumoretinopexy operation was performed by making intravitreal injection of C3F8 gas. Results. On the first day after the operation, complete blocking of the rupture under the gas bubble with full fit of the mesh shell was fixed. The boundaries of the field of view were expanded, the veil disappeared. In the laser center, restrictive laser coagulation was performed around the rupture under the gas bubble. Conclusions. The operation was performed under local anesthesia and did not require hightech equipment. Due to the microinvasiveness of the intervention, the patient managed to maintain high visual functions, avoid removal of the native lens and vitreous. Keywords: pneumoretinopexy, retinal detachment, surgical treatment of retinal detachment, gas tamponade, minimally invasive procedure

First Nation-Wide Study of the Incidence and Characteristics of Retinal Detachment in Poland during 2013–2019

The present study aimed to analyze the incidence and characteristics of all types of retinal detachment (RD) in the overall population of Polish adults during 2013-2019. Data from all levels of healthcare services at public and private institutions recorded in the National Health Fund (NHF) database were evaluated. International Classification of Diseases codes (ICD-9 and ICD-10) and unique NHF codes were used to identify RD patients and RD treatment procedures. In the period 2013-2019, 71,073 patients with RD were newly diagnosed in Poland. The average incidence was 32.64/100,000 person-years (95% CI: 31.28-33.99) and it increased with the age of patients, with the highest rate in the group of patients ≥70 years of age. The overall incidences of rhegmatogenous RD, traction RD, serous RD, other RD and unspecified RD were 13.72/100,000, 2.03/100,000, 1.02/100,000, 7.90/100,000 and 7.97/100,000 person-years, respectively. The most common surgical treatment for RD in Poland was PPV performed on average in 49.80% of RD patients. The risk factor analyses showed that rhegmatogenous RD was significantly associated with age (OR 1.026), male sex (OR 2.320), rural residence (OR 0.958), DM type 2 (OR 1.603), any DR (OR 2.109), myopia (OR 2.997), glaucoma (OR 2.169) and uveitis (OR 2.561). Traction RD was also significantly associated with age (OR 1.013) and male sex (OR 2.785) as well as with any DR (OR 2.493), myopia (OR 2.255), glaucoma (OR 1.904) and uveitis (OR 4.214). Serous RD was significantly associated with all analyzed risk factors except DM type 2. The total incidence of retinal detachment in Poland was higher than found in previously published studies. Our study demonstrated that diabetes type 1 and diabetic retinopathy are risk factors of development of serous RD, which is presumably associated with the disruption of the blood-retinal barriers in these conditions.

The role of the volume of endolaser coagulation in the appearance of perisilicone proliferation in retinal detachment surgery

Background. Endolaser coagulation (ELС) is an integral part of endovitreal retinal detachment (RD) surgery. The study of the role of ELC volume (total laser energy and the amount of applied coagulates) in the formation of perisilicone oil proliferation (POP) after RD surgery of various origins is necessary to prevent postoperative complications.The purpose of this study was to study the role of the ELC volume in the formation of POP in RD surgery of various genesis.Materials and methods. The study was conducted in the private clinic “SIHAT KO’Z” from 2019 to 2021. 88 (88 eyes) patients with retinal detachment of different genesis were examined. The age range varied from 21 to 67 years, the average age was 47.4 ± 3.1 years. 61 (69%) patients had rhegmatogenous RD, 27 (31%) tractional RD. The macular area was involved in RD in 64 (73%) cases, and was intact in 24 (27%) cases.Results. In 11 patients PP formed the day after surgery, in 4 (4.5%) exudate and fibrin were formed in the anterior chamber, in 4 (4.5%) re‑injection of silicone oil was required due to incomplete retinal adhesion. In 2 (2.3%) cases iridocorneal adhesions were formed. The study showed that the occurrence of the above complications was directly related to the intensive effect of ELC during surgery for retinal detachment.Conclusion. Thus, increased coagulation and energy volume in ELC during surgical treatment of retinal detachment is important in the occurrence of PP. The analysis revealed a clear relationship between the development of a proliferative membrane and the volume of ELC. Since PP is a factor that reduces the effectiveness of surgical treatment of retinal detachment, the recommendation is to reduce the volume of ELC to the minimum necessary.

RESULTS OF SURGICAL TREATMENT OF RETINAL DETACHMENTS DUE TO BLUNT EYE INJURY

The article analyzes the surgical treatment of 96 patients who underwent surgery for retinal detachment. The cause of retinal detachment in all cases was an eye contusion. The author analyzed the age, gender, visual acuity before and after surgery, the cause of contusion, the time of onset of retinal detachment, concomitant pathology, type of retinal tear, surgical technique, results of ophthalmological examinations in the pre- and postoperative period, postoperative complications. The factors that affect visual functions in the early and late postoperative period were determined. Visual acuity after surgery depends on the initial visual acuity. Delaying the time of surgery leads to a decrease in visual functions in the postoperative period. Proliferative vitreoretinopathy and traumatic optic neuropathy were the most common complications that led to vision loss 6 months after surgery. Traumatic optic neuropathy is the result of trauma and is not associated with surgery. There are no effective treatments. Proliferative vitreoretinopathy is a complication of surgical treatment of retinal detachment. Repeated surgical treatment does not improve vision.

Комбинированное лечения отслойки сетчатки на фоне периферического ретиношизиса

Modern approaches to surgical treatment of retinal detachment against the background of peripheral retinoschisis do not always give the desired result. Purpose. The purpose of the presented clinical case is to evaluate the effectiveness of the use of autologous conditioned plasma (AСP) in the treatment of regmatogenic retinal detachment against the background of peripheral retinoschisis. Material and methods. In the ophthalmological department of the Northwestern State Medical University named after I.I. Mechnikov, a patient P., born in 1959, was under observation with a diagnosis of regmatogenic retinal detachment in case of peripheral retinoschisis. The patient underwent microinvasive vitrectomy with the introduction of ACP into the intraretinal space, endolaser retinopexy, endotamponade of PFOC with replacement on silicone oil. Results. In the postoperative period, there was a complete fit of the retina throughout. Conclusions. The first experiment gave an excellent result, which opens new prospects for patients with regmatogenic retinal detachment in case of retinoschisis. However, further research in this direction is required. Keywords: retinal detachment, retinoschisis, peripheral retinoschisis, ACP.

Вопросы организации помощи пациентам с регматогенными отслойками сетчатки в условиях региональной медицины

The aim of the work was to analyze the features of the organization of care for patients with regmatogenic retinal detachment in regional medicine. Material and methods. Our clinic performs all the necessary types of surgical treatment for retinal detachment. Part of the ophthalmological services is paid from the funds of the compulsory medical Insurance for CSG. Results. The incidence of regmatogenic retinal detachment varies at the level of 11–12 per 100 thousand population. The analysis showed that during retinal detachment surgery, when payment is made according to the rates of the compulsory medical insurance, there are nuances of purchasing special equipment and consumables for VRH. In addition, the issues of surgery are ambiguous and due to the lack of approved clinical recommendations for retinal detachment and clearly established guidelines, as a result of which the terms of hospitalization and treatment of patients with these diseases are blurred, there are problems of interchangeability of surgeons. Conclusion. The provision of surgical care in the Kirov region to patients with retinal detachment at the expense of the CHI Fund ensures the availability and timeliness of medical services. The clinic is equipped with modern equipment, the provision of highly qualified specialists allows us to provide high-quality care even in the most difficult cases. Extrascleral surgery does not lose its relevance, despite the rapid development of endovitreal techniques. Keywords: retinal detachment, organization of care, regional medicine.

Анализ результатов пневморетинопексии при хирургическом лечении регматогенной отслойки сетчатки

Introduction. Pneumoretinopexy is low-traumatic and minimally invasive technique for treatment retinal detachment. Purpose. Analysis clinical efficacy of pneumoretinopexy in treatment rhegmatogenous retinal detachment. Material and methods. 9 patients (9 eyes) aged 35 to 67 years (all women) were selected. Selection criteria: rhegmatogenous retinal detachment, the presence of one or two horseshoe retinal tear in the superior meridians. Results. On 3–5th days, all 9 patients had blockage of retinal tear, in 4 eyes the height of the retinal detached significantly decreased, in 5 patients had complete reattachment of the retina. Barrier laser retinal photocoagulation of the areas of retinal tears was performed, a barrier of coagulates was formed around the blocked tears. Patients were discharged on the 7 th day. Recurrent retinal detachment occurred in 2 patients (2 eyes). At the end of the follow-up period, after complete gas resorption in the vitreous chamber, visual acuity in all patients increased above 0.1, on average – 0.3. Conclusion. Pneumoretinopexy is effective in recent cases of rhegmatogenous retinal detachment with follow-up periods of up to 1 month. Pneumoretinopexy should be used with caution in eyes with pseudophakia; on the eyes with large retinal tears in the meridian below 1–11 o'clock meridians. Keywords: pneumoretinopexy, retinal detachment, recurrent retinal detachment, surgical treatment of retinal detachment.

Results of surgical management of the retinal detachment in pediatric patients with Marfan and Stickler syndrome

Background: The purpose of this study was to report the anatomical and functional outcomes in the surgical treatment of retinal detachment (RD) in pediatric patients suffering from Marfan (MFS) and Stickler syndrome (SS). Material and methods: Retrospective consecutive case series of eight eyes of four patients with SS and MFS. Retinal reattachment and visual acuity, as well as complications of surgical procedures have been evaluated during the follow-up period. Results: Total RD was reported in five of the eight eyes of these patients. In one patient, it was bilateral. As a surgical treatment, pars plana vitrectomy (PPV) with silicone oil was performed in four eyes. Proliferative vitreoretinopathy was the reason for the secondary PPV in three eyes. Scleral buckling was conducted in two eyes of bilateral RD. Laser treatment was performed as prophylaxis in all fellow eyes. The visual acuity in eyes with RD ranged from light perception to 0.1 in two cases. The retina was finally attached in all cases. Imaging with OCT-A in a patient with SS revealed a reduced vascular density in the eye after PPV compared to the eye treated with laser. Conclusions: Multiple surgical procedures are needed to attach the retina in patients with SS and MFS. However, despite the improvement of anatomical conditions — reattachment of the retina, the visual acuity after RD surgery is not satisfactory in patients suffering from SS and MFS.

Morphological changes in eyes after suprachoroidal high-frequency electrosurgical treatment of the retina

A variety of methods and approaches are used for the surgical treatment of retinal detachment, among which high-frequency electrocoagulation through the suprachoroidal access has attracted the attention of researchers. The research question concerned the selection of the optimal mode of electrocoagulation with the help of a monopolar instrument of the original design, during which a strong chorioretinal adhesion occurs in a short period of time after surgical intervention, there is no need for tamponade, and the destruction of cells of chorioretinal structures is minimized, which is associated with the temperature factor of electrocoagulation. The study was conducted on 52 rabbits (104 eyes), which were divided into 4 groups: Group I – exposure voltage 10–12 V, frequency 66 kHz, current strength 0.1 A (16 animals, 32 eyes); Group II – exposure voltage 12–14 V, other parameters are identical (16 animals, 32 eyes); Group III – exposure voltage 14–16 V, other parameters are identical (16 animals, 32 eyes); Group IV– 4 intact rabbits, 8 eyes (control). The animals were euthanized, the eyes were enucleated. Fragments with areas after electrocoagulation were fixed on a device of the original design, which measured the strength of the chorioretinal adhesion on an electronic jewelry scale by pulling a thread tied to the sample until the sample ruptured. The tissues of the chorioretinal complex were also studied by light microscopy after staining histological sections with hematoxylin-eosin. According to indicators of chorioretinal junction strength, the optimal exposure voltage was 10–12 V. Destruction of cells of the chorioretinal complex at this voltage did not differ from destruction using voltages of 12–14 V and 14–16 V, but the strength of chorioretinal junction was the greatest after 1 hour. 1 week and 2 weeks after surgery. Keywords: high-frequency electrocoagulation, chorioretinal surgery, retinal detachment, strength of chorioretinal adhesion.

Субретинальная пролиферация. Что делать?

Purpose. Evaluation of treatment results retinal detachment complicated by subretinal PVR. Materials and methods. We examined 13 patients (13 eyes) with operated retinal detachment (RD), subretinal proliferative vitreoretinopathy (PVR). In the main group (7 eyes) with recurrence of retinal detachment RD was complicated by severe subretinal proliferation. Аll the patients underwent surgical treatment of retinal detachment with removal of the subretinal PVR; in the control group (6 eyes) subretinal proliferation was localized in the zone of the adjacent retina and its removal was not performed. Results. The compared groups did not differ in terms of age and gender, the axis length of the eye. Duration of the RD was more than 3 months. During the observation period of 6 months of patients both groups, in all cases, it was possible to achieve a fit of the retina. Conclusion. 1. Subretinal PVR should be removed when it is localized in the macular area, or when it leads to retinal detachment, preventing it from fitting with standard technical manipulations. 2. Potential of microinvasive vitreoretinal surgery allow to effectively eliminate subretinal PVR, complementing standard manipulations, with a good functional and anatomical result. Keywords: retinal detachment, proliferative vitreoretinopathy, anatomical outcome.

Endothelial corneal cell damage after pars plana vitrectomy: analogy of different intraocular tamponade agents.

A reduction in the corneal endothelial cells multitude after anterior pole intervention is well established in numerous researches, but there are few articles that follow the impact of vitreoretinal interventions on the cornea, especially when endotamponade agents are used. The assessment of the endothelial corneal cells is needed since it facilitates the personal evaluation of the functional endothelial stock. Specular microscopy investigation offers a scale of the functional strength of the endothelium of cornea, which is vital before all intraocular interventions.Endotamponade agents are very suitable and important tools in the surgical treatment of retinal detachment, but their use must be differentiated depending on the uniqueness of each patient. This research shows corneal endothelial damages caused by intraocular tamponade agents of different types in the case of pars plana vitrectomy for cases of multitude retinal detachments. The purpose of the research was to determine the changes that appear in the endothelium of the cornea and to deal with the results when different tamponade agents are used in the surgical cure for retinal detachment. Specular endothelial corneal microscopy records were achieved and the modifications of the following parameters revealed corneal implication: mean endothelial cell densities, average cell area, coefficient of variation, hexagonality and corneal center thickness. On the first day and at three months postoperatively, a statistically significant reduction was observed for the CV, MCD, and HEX parameters (p 0.001), but no statistically significant difference of the two endotamponade agents (for MCD, p=0.15; for CV, p=0.63; for HEX, p=0.93) was noticed. AVG parameter had a statistically significant decrease (p 0.001) and there was also a statistically significant difference of the two endotamponade agents (p=0.03), patients with gas tamponade presenting a superior result. On the first day and at three months postoperatively, the corneal center thickness presented a statistically significant increase (p 0.001) and there was a statistically significant difference between the two endotamponade agents (p=0.03), patients with gas endotamponade presenting a superior result. In conclusion, using the intraocular tamponade agents helps reestablish the functional-anatomical recovery of the retina after surgery, but their special indication must be well-established for each case of retinal detachment.

Результаты хирургического лечения регматогенной отслойки сетчатки с макулярным разрывом

Purpose. Analysis of functional and anatomical results surgical treatment of retinal detachment and macular hole (RDMH) with internal limiting membrane (ILM) peeling and silicone tamponade. Material and methods. Analysis of results surgical treatment of 17 patients (17 eyes) with RDMH was carried out. Disease duration ranged from 2 weeks to 3 months. Visual acuity before surgical treatment ranged from no light perception to 0.05 (on average 0.01±0.02). All patients underwent endovitreal surgery with ILM removal. Then retinal holes were localized at periphery with further endolaser coagulation or cryocoagulation and silicone oil (5700 cSt) tamponade. Results. Retinal adhesion was noted in all eyes after primary surgery. Closure of hole was successful in 16 patients. After operation, visual acuity improved in all patients, averaging 0.11±0.09. Conclusion. Vitrectomy with IPM removal and silicone oil (5700 cSt) tamponade in treatment of RDMH made it possible to achieve reattachment of retina in 17 patients, complete closure of macular hole in 16 of 17 patients. One patient, according to optical coherence tomography, showed decrease diameter of macular hole after 12 months. Positive functional effect was achieved in increase visual acuity to average of 0.15±0.15 after 12 months. Key words: retinal detachment, macular hole, vitrectomy, internal limiting membrane removal, silicone oil tamponade, visometry, optical coherence tomography.

Functional results of surgical treatment of retinal detachment

The article analyzes the state of patients visual acuity after successful surgical treatment of retinal detachment. On the basis of gathered data, it was concluded that in case of detachment of the macula only in 50% of cases it is possible to increase visual acuity to 0.4 and higher. Restoration of visual functions continues for at least 6 months after the operation and is determined by the restoration of the structure of the outer segments of the photoreceptor cells. During this time, it is advisable to conduct drug therapy aimed at normalizing blood flow and functional activity of the retina. Visual functions recovery continues for at least 6 months after the operation and is connected with the restored structure of the outer segments of the photoreceptor cells. Important prognostic factors of central vision restoration in the postoperative period are visual acuity before surgery, duration of existence and height of macular detachment. Data on which of the methods of surgical treatment of retinal detachment allows to achieve higher visual acuity are contradictory. There is practically no data on the comparison of the effect on visual acuity of scleral buckling and vitrectomy in the long-term period, in patients with phakic eyes and with artiphakia. On visual acuity after fitting detachment of the macula may affect macular edema, epiretinal membrane formation and retinal folds, and edema of the peripapillary optic nerve head, progressive deterioration of blood flow in the basin of the central retinal artery, short posterior ciliary arteries and ophthalmic artery. It is believed that these factors are significantly more pronounced after scleral buckling than after vitrectomy. Some indicators of optical coherence tomography correlate with visual acuity after surgical treatment of retinal detachment: the state of the articulation line of the external and internal segments of the photoreceptors, as well as the state of the external limiting membrane.

Применение аутологичной кондиционированной плазмы в хирургическом лечении отслойки сетчатки, осложненной макулярным разрывом

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Outcomes of surgery in eyes with familial exudative vitreoretinopathyassociated retinal detachment

ObjectiveThe aim of this study was to evaluate various techniques of surgical treatment of retinal detachment associated with familial exudative vitreoretinopathy (FEVR) and the factors affecting the anatomical and visual outcome. DesignRetrospective case series. ParticipantsPatients diagnosed with FEVR associated retinal detachment and operated for the same between January 2004 and September 2017. MethodsA retrospective chart review was conducted of all patients diagnosed with FEVR between January 2004 and September 2017. Patients with rhegmatogenous retinal detachment (RRD) and tractional retinal detachment (TRD) were included for analysis. Statistical analysis was performed using the t test for mean visual acuities, Fisher's exact test for categorical data, and the one-way analysis of variance for visual outcomes among surgical management options. ResultsA total of 44 eyes of 38 patients diagnosed with FEVR-associated retinal detachment and operated for the same were evaluated. At the time of initial presentation, the mean age of the 38 patients was 14.6 ± 10.9 years and 57.8% were males. Out of 44 eyes that underwent surgical intervention, 79.5% cases were of RRD (n = 35), and TRD was seen in 20.5% cases (n = 9). Primary management in the form of scleral buckle was done in 14 (31.8%) eyes, with 11 eyes (78.6%) having an attached retina after a single surgery and 85.7% after multiple surgeries. Primary pars plana vitrectomy (PPV) was done in 30 (68.2%) eyes, of which 73.3% had attached retina after single surgery and 83.8% after multiple surgeries. Poor pre-operative best-corrected visual acuity, presence of TRD, and presence of falciform folds were associated with poor anatomical outcome. ConclusionsFavourable outcomes can be achieved, though multiple surgical interventions may, however, be necessary for the ultimate success in some cases.

Pattern‐stimulation in the complex management of patients with operated retinal detachment

AbstractIntroductionThe problem of increasing visual function after surgical treatment of retinal detachment retains its relevance. Existing methods do not take into account the possibilities of the retinal‐cortex system stimulation.ObjectiveEvaluation of the functional effect of pattern‐stimulation in the complex management of retinal detachment operated patients.Patients and methodsForty patients with an extrascleral retinal procedure. The median of age is 53.6 [23; 75] years. Patients in group 1a (10 eyes with macula‐on before surgery) and 1b group (with macula‐off before surgery) underwent a course of drug therapy (peptides, meldonium, antioxidants), patients of group 2a (10 eyes macula‐on before surgery) and 2b Groups (macula‐off before surgery) – a similar course of drug treatment combined with a pattern‐stimulation course. All groups are comparable in age, sex, visual acuity, data of electrophysiological studies – macular electroretinogram (ERG), visual evoked cortical potentials (VECP). According to the results of optical coherent tomography carried out before the start of treatment, there were no gross organic changes in the area of the macula in patients. Starting treatment 6 months after surgery. Evaluation of the treatment effectiveness after 3 months after its completion.ResultsIncreased visual acuity after treatment in group Ia occurred at 0.05, in group Ib by 0.03, in group IIa by 0.17, in group IIb by 0.21. The amplitude of wave‐a of macular ERG increased by 4.07 mV in group Ia, by 5.4 mV in group Ib, by 2.9 mV in group IIa, by 8.17 mV in group IIb; changes in wave amplitude‐in different directions: in group Ia, an increase of 3.5 mV, in group Ib a decrease of 0.4 mV, in group IIa and IIb an increase of 5.19 mV and 10.86 mV, respectively. VECP N 75 latency decreased by group Ia by 1.46 ms, by group 19.2 ms by group IIa, by 14.94 ms by group IIb, and increased by 1.1 ms by group Ib; P100 decrease in groups: Ia by 0.93 ms, IIa by 14.39 ms, IIb by 14.94 ms, increase in group Ib by 1.2 ms; the amplitude of the N75‐P100 VECP wave increased in all groups: Ia by 1.3 mV, Ib by 1.55 mV, IIa by 3.48 mV, IIb by 10.58 mV. An increase in visual acuity on the background of drug treatment correlated with an improvement in the amplitude characteristics of the local ERG (r = 0.47), using pattern stimulation with an increase in the amplitude characteristics of the VECP (r = 0.46).ConclusionUsing the stimulation pattern in complex management of the retinal detachment operated patients helps to improve the amplitude indices of local ERG and VECP by more than three times, reducing VECP latency values, increasing visual acuity 4 times in comparison with the routine drug therapy results in patients 1a and 1b groups. The results obtained indicate the feasibility of using the method of pattern‐stimulation in patients with operated retinal detachment to enhance the functional effect of surgical treatment.

Опыт хирургического лечения отслойки сетчатки с тампонадой витреальной полости воздухом

Опыт хирургического лечения отслойки сетчатки с тампонадой витреальной полости воздухом