scholarly journals Modern extrascleral surgery in the treatment of regmatogenous retinal detachment: efficacy evaluation and functional results

2020 ◽  
Vol 12 (4) ◽  
pp. 23-28
Author(s):  
Andrey D. Shchukin
Keyword(s):  
Visual Acuity ◽  
Surgical Treatment ◽  
Retinal Detachment ◽  
20Th Century ◽  
Functional Results ◽  
Independent Method ◽  
City Hospital ◽  
Efficacy Evaluation ◽  
Basic Principles ◽  
The City

The basic principles of extrascleral surgery, which are currently used in the treatment of regmatogenous retinal detachment (RD), have not changed much since their heyday in the 7080s of the 20th century, and they remain relevant both as an independent method to treat this disease in certain clinical cases, and in combination with vitrectomy. The aim is to evaluate the efficacy of RD extrascleral treatment methods (anatomical result, visual acuity), as well as the frequency and timing of the relapses. Materials and methods. The study was carried out at the vitreoretinal department of the Ophthalmological Center of the City Hospital No. 2 of St. Petersburg. A sample of 466 patients with RD, operated with extrascleral methods in 20152016 has been analyzed. Anatomical results, visual acuity, number and timing of relapses have been assessed. Results. The efficacy of extrascleral surgery reaches 89%, RD recurrence after surgical treatment occurs in 21% of patients.

scholarly journals On functional results of treatment of recurrent rhegmatogenous retinal detachment after multiple endovitreal interventions

2019 ◽  
Vol 12 (2) ◽  
pp. 5-10
Author(s):  
Andrei D. Shchukin
Keyword(s):  
Retinal Detachment ◽  
Rhegmatogenous Retinal Detachment ◽  
Present Report ◽  
Vitreoretinal Surgery ◽  
Functional Results ◽  
Scleral Buckling ◽  
City Hospital ◽  
Results Of Treatment ◽  
The City ◽  
Retinal Photocoagulation

The present report is an extension of the study, in which on a large clinical material, the ratio of procedures used at this time for retinal detachment was shown, and the frequency of relapses after extrascleral and endovitreal surgeries was analyzed. The purpose of the study is to determine the terms of relapse occurrence, and to estimate visual function after multiple endovitreal procedures. Materials and methods. The study was carried out in the Ophthalmological Center of the City Hospital No. 2 of St. Petersburg. The data of 116 case histories of 23 patients (28 eyes) repeatedly admitted to the department of vitreoretinal surgery of the center and operated (2 to 7 times) for recurrent rhematogenous retinal detachment in 2015-2016 were analyzed. Results. Multistage endovitreal surgery in patients with recurrent retinal detachment in most cases (78.6%) leads to significant decrease of visual functions; in incomplete retinal adherence in the lower segments after extrascleral surgery, additional scleral buckling or barrier laser retinal photocoagulation can be used.

scholarly journals Functional results of surgical treatment of retinal detachment

2020 ◽  
Vol 24 (2) ◽  
pp. 156-162
Author(s):  
O. E. Ilyukhin ◽  
M. A. Frolov ◽  
K. V. Ignatenko
Keyword(s):  
Blood Flow ◽  
Visual Acuity ◽  
Surgical Treatment ◽  
Retinal Detachment ◽  
Photoreceptor Cells ◽  
Functional Results ◽  
Scleral Buckling ◽  
The State ◽  
Visual Functions ◽  
Outer Segments

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.

Clinical analysis and efficacy of bimanual surgical treatment of retinal detachment in severe forms of proliferative diabetic retinopathy with preoperative preparation with anti-VEGF drugs in combination with the use of the Ngenuity ALCON 3D imaging system

2021 ◽  
pp. 195-198
Author(s):  
D.V. Chernykh ◽  
Keyword(s):  
Visual Acuity ◽  
Diabetic Retinopathy ◽  
Surgical Treatment ◽  
Retinal Detachment ◽  
Postoperative Period ◽  
3D Imaging ◽  
Imaging System ◽  
3D Visualization ◽  
Preoperative Preparation ◽  
Anti Vegf

The purpose of the study was to evaluate the effectiveness of bimanual surgery with anti-VEGF preparation of patients with severe forms of PDR complicated by traction retinal detachment, with intraoperative use of 3D visualization. Material and methods. Operated on 18 patients with a diagnosis of PDR complicated by traction retinal detachment. Of these, there were 7 patients with type 1 diabetes, type 2 diabetes. There were 5 men and 13 women. The average age was 58 + -2 years. All patients underwent a three-port vitrectomy, using an additional light source, with preoperative preparation with anti-VEGF drugs, using bimanual technique and 3D visualization, using air tamponade. Results and its discussion. As a result of the study, it was found that the visual acuity before the treatment was 0.03 [0.01; 0.1], and 4-6 months after the surgical treatment, 0.3 [0.15; 0.5]. The performed statistical analysis made it possible to establish a statistically significant increase in visual acuity 4-6 months after the treatment. (p = 0.001) Achieved complete anatomical retinal fit. With increased visual acuity. There were 5 complications in the postoperative period. Recurrent hemophthalmos was diagnosed in 3 people, which required repeated surgical intervention. In 2 patients in the postoperative period, DMO developed, which required IVI biodegradable dexamethasone implant. Conclusion. Bimanual, surgical treatment of traction retinal detachments, in severe forms of PDLP, with preoperative preparation with anti-VEGF drugs, and the use of the Ngenuity ALCON 3D imaging system, is one of the effective methods of treatment in this group of patients, and is aimed at reducing both intra and postoperative complications. Key words: рroliferative diabetic retinopathy, vitrectomy, 3D imaging, bimanual surgery, anti-VEGF drugs.

The first experience of using autologous conditioned plasma in the surgery of complete macular ruptures in the Voronezh Regional Clinical Ophthalmological Hospital

2021 ◽  
pp. 140-143
Author(s):  
A.A. Roldugin ◽  
◽  
O.V. Donkareva ◽  
S.Y. Shcherbakov ◽  
◽  
...  
Keyword(s):  
Visual Acuity ◽  
Surgical Treatment ◽  
Clinical Observation ◽  
High Efficiency ◽  
Standard Technique ◽  
Functional Results ◽  
Dark Spot ◽  
High Tech ◽  
Early Results

Purpose. To evaluate the effectiveness of the use of autologous conditioned plasma in the surgical treatment of complete macular ruptures. Material and methods. During 2021, 4 patients with complete macular rupture were operated on at the center of ophthalmic microsurgical high-tech care of the Voronezh Regional Clinical Ophthalmological Hospital using autologous conditioned plasma. The BCVA was 0.01–0.3. The diameter of the macular breaks ranged from 214 to 817 µm. Blood samples were taken from the patients before the operation. Autologous conditioned plasma was prepared by centrifuging the patient's blood in a patented Arthrex ACP (Germany) double-circuit syringe. Surgical treatment was carried out according to the standard technique - microinvasive three-port 25G vitrectomy with removal of the BMR to the extreme periphery and IPM in the central part of the retina. After tamponade of the vitreous cavity with air, autologous conditioned plasma was injected intravitreally into the central and peripheral rupture in several layers until a visual film appeared. The follow-up period for patients after surgical treatment was 2 months. Results. When examining patients after 1 week, the edges of the macular foramen remained closed in all cases. All studied patients noted an improvement in visual functions, the absence of metamorphopsia, a decrease in the dark "spot" in front of the eye, visual acuity ranged from 0.2 to 0.7 (0.5 + 0.2) after surgery for a complete macular rupture, and 0.02 in patients after surgery for recurrent macular rupture. After 1 month, the visual acuity after the full macular rupture was repaired after 1 month was 0.3–0.8 (0.6 ± 0.2), which was significantly higher than the preoperative values, and did not change in the patient with recurrent macular rupture. Two months later - the results of optical coherence tomography and visometry without negative dynamics. Conclusions. The early results of clinical observation confirmed the high efficiency of the use of autologous conditioned plasma in the surgical treatment of complete macular ruptures, which allows to obtain high functional results and anatomical closure of the macular rupture, to increase the efficiency and safety of rehabilitation. Key words: macular rupture, autologous conditioned plasma.

scholarly journals Surgical treatment of retinal detachment with inferior break using combined gas-air tamponade with viscoelastic

2021 ◽  
pp. 52-56
Author(s):  
I.M. Gorshkov ◽  
◽  
D.O. Shkvorchenko ◽  
A.V. Yukhananova ◽  
A.A. Shpak ◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Surgical Treatment ◽  
Retinal Detachment ◽  
Rhegmatogenous Retinal Detachment ◽  
Clinical Observation ◽  
Sodium Hyaluronate ◽  
Functional Results ◽  
Air Tamponade ◽  
New Surgical Technique

Surgical treatment of rhegmatogenous retinal detachment with an inferior break remains a challenge for ophthalmic surgeons. When using silicone tamponade, complications can develop, such as increased intraocular pressure and emulsification of silicone. In recent years, tamponade of the vitreous cavity with a gas-air mixture has been actively used, however, not all patients can observe the forced position face down, and the tamponade itself is not long-term. Purpose. The authors proposed a method for the treatment of rhegmatogenous retinal detachment with an inferior break using a combined tamponade with a gas-air mixture and viscoelastic based on sodium hyaluronate. Material and methods. A clinical observation of a patient successfully operated on with the use of the specified combined tamponade is presented. A detailed description of a new surgical technique is presented, which allows achieving a higher anatomical and functional results. Conclusion. To confirm the effectiveness and safety of the proposed method, further studies on a group of patients are needed. Key words: rhegmatogenous retinal detachment, inferior break, gas-air tamponade, tamponade with viscoelastic, sodium hyalur onate

scholarly journals Development of Hand Surgery in Ukraine

2020 ◽  
pp. 75-82
Author(s):  
S.S. Strafun ◽  
O.V. Borzykh ◽  
I.M. Kurinnyi ◽  
D.V. Ivchenko ◽  
S.I. Bilyi ◽  
...  
Keyword(s):  
Upper Extremity ◽  
20Th Century ◽  
Reconstructive Surgery ◽  
Rapid Development ◽  
Hand Surgery ◽  
City Hospital ◽  
Skilled Assistance ◽  
Rapid Industrialization ◽  
High Level ◽  
The City

Summary. During the period of rapid industrialization, there was a need to create a new approaches to treat hand injuries due to rapid development of metallurgical, mining and engineer industry, which were accompanied by a high level of injuries with a significant amount of disability in the second half of 20th century, in Donetsk, Dnipropetrovsk and Kharkiv regions. New stage in the development of hand surgery and microsurgery in Ukraine began in the 80’s: the Department of Microsurgery and Reconstructive Surgery of the Upper Extremity under the direction of I. Antoniuk was opened on the basis of the SI “Institute of Traumatology and Orthopedics of NAMS of Ukraine” in Kyiv in 1982. Development of hand surgery in the western regions of Ukraine began in the 90’s. In Lviv, on the initiative of O. Toropovskyi, on the basis of the City Hospital No 8, a Center of Microsurgery and Surgery of the Hand was created. In Zakarpattia (Uzhhorod) since 1997, on the initiative of V. Haiovich and A. Pogoriliak, microsurgery and hand surgery service was established, which is now under the care of the Combustiology Department. In Volyn (Lutsk), hand surgery service is transmitted to the initiative group, also working at the City Combustiology Center. In Ivano-Frankivsk, Chernivtsi, Ternopil and Rivne, initiative groups in the field of hand surgery service have been formed in the structure of orthopedics and traumatology departments. 2005 was marked by the opening of another center for surgery of the hand in Luhansk on the initiative of V. Ivchenko and under the guidance of V. Golovchenko, whose surgeons owned microsurgical equipment and provided highly skilled assistance to the population of this region. Ukrainian Hand Surgery Society (UHSS) was created in 2012, and led by Professor S. Strafun, as a result of collaboration of all hand surgery centers. In 2014, UHSS was accepted into the Federation of European Societies for the Surgery of the Hand (FESSH).

scholarly journals Optimization of surgical treatment of cataract in patients with diabetes mellitus

2010 ◽  
Vol 13 (2) ◽  
pp. 91-93
Author(s):  
Dmitriy Valentinovich Lipatov ◽  
Timofey Alexandrovich Chistyakov ◽  
Anatoliy Gennad'evich Kuz'min
Keyword(s):  
Visual Acuity ◽  
Surgical Treatment ◽  
Combined Treatment ◽  
Functional Results ◽  
Early Postoperative Period ◽  
Lens Opacity ◽  
Research Centre ◽  
Diabetic Cataract ◽  
Ocular Tissues ◽  
Patients With Diabetes

Aim. To compare different methods for surgical treatment of cataract in patients with diabetes melli-tus (DM) and substantiate the choice of its optimalmodality. Materials and methods. Analysis included data on 209 patients (221 eyes) treated from January 2008 to December 2009 in the Department ofRetinopathy and Ophthalmosurgey, Endocrinological Research Centre. Diabetic cataract was managed using UNIVERSAL-II, LEGACY EVEREST,and INFINITI phacoemulsifiers. Parameters studied included time of ultrasound (US) ex-posure, US power, and retinal characteristics in the earlypostoperative period. In addition, analysis included data on the location of lens opacity in 1047 patients (1897 eyes) with diabetic cataract. Results. Relatively low corrected and uncorrected visual acuity in the early postoperative period was attributable to concomitant DM-related retinalpathology. Analysis of lenticular opacity showed that it in the first place affected collagen fibers beneath the posterior capsule. The use of torsional USin INFINITI for cataract phacoemulsification produced almost 4-fold reduction in the exposure time of ocular tissues. As a result, the postoperativeoedema was significantly smaller than in patients undergoing combined treatment (AQUALASE hydromonitoring and OZIL ultrasound system). Conclusion. Combination of ultrasound and hydromonitoring phacoemulsification for the treatment of cataract in DM patients reduces exposure timeof ocular tissues and postoperative oedema which creates prerequisites for faster recovery of visual acuity after surgery. Functional results of surgicaltreatment of diabetic cataract can be further improved by early diagnosis of lens opacity and the use of US and hydromonitoring phacoemulsificationtechniques.

Rhegmatogenous Retinal Detachment in Children

2020 ◽  
pp. 29-35
Author(s):  
O.V. Diskalenko ◽  
◽  
O.A. Konikova ◽  
V.V. Brzheskiy ◽  
◽  
...  
Keyword(s):  
Visual Acuity ◽  
Surgical Treatment ◽  
Retinal Detachment ◽  
Treatment Efficacy ◽  
Rhegmatogenous Retinal Detachment ◽  
Clinical Course ◽  
Vitreoretinal Surgery ◽  
Scleral Buckling ◽  
Stickler Syndrome ◽  
Pediatric Practice

Purpose. To study the etiological structure of rhegmatogenous retinal detachment, the efficacy and outcomes of its surgical treatment in pediatric practice. Material and Methods. A retrospective series of cases in one vitreoretinal center in 2015–2019 was presented. The age of the children with rhegmatogenous retinal detachment (57 patients / 66 eyes) was from 0 to 18. Surgical treatment included vitreoretinal and scleral buckling techniques. Results. Rhegmatogenous retinal detachment in 30.3% of cases developed against the background of ROP, in 24.2% – against the background of Stickler‘s syndrome, in 12.1% – against the background of myopia, in 12.1% – against the background of trauma, and in 21.3 % – against the background of other reasons. On average, the anatomical treatment efficacy was 77.4%. The leading factors of an unfavorable outcome of treatment were the duration of presence of retinal detachment (OR 21.44; CI 3.76– 122.16) and 3–5 stages ROP (OR 2.56; CI 0.76–8.44). Visual acuity exceeding the blindness threshold (Vis > 0.02) was maintained or achieved in 72% of cases. Conclusions. The specificity of the clinical course and adherence to surgical treatment of children with rhegmatogenous retinal detachment is determined by its etiology. Key words: retinal detachment in children, Stickler syndrome, retinopathy of prematurity, scleral buckling, vitreoretinal surgery.

scholarly journals Surgical Treatment of Previously Unclosed Macular Holes

2020 ◽  
Vol 17 (3) ◽  
pp. 368-374
Author(s):  
R. R. Faizrakhmanov ◽  
E. A. Larina ◽  
O. A. Pavlovskii
Keyword(s):  
Visual Acuity ◽  
Surgical Treatment ◽  
Macular Hole ◽  
Free Flap ◽  
Inverse Correlation ◽  
Functional Results ◽  
Internal Limiting Membrane ◽  
Morphological Parameters ◽  
Photoreceptor Layer ◽  
Macular Holes

Macular holes are the most often pathology leading to reduced vision among persons after 60 years. The macular hole is the acquired disease which is a defect of a foveola part of retina on all thickness from an internal limiting membrane to an external segment of a photoreceptor layer. The standard method of treatment is surgery method: a microinvasive vitrectomy with membrane peeling in macular area. There is a number of the techniques increasing efficiency of operative intervention. Even in case of successful surgical intervention macular holes are not always closed.The purpose: development and assessment of morphological parameters of the central retina with a new surgical method of closing earlier operated macula hole using a free flap.Material and methods. 40 patients (40 eyes, 28 women and 12 men) had participated in this study. All patients were operated about macular hole with negative anatomic result. By technology which were used earlier, patients were divided into 3 studied groups (with PRP mass using, with introverted flap using, with mechanical matching of edges of a hole). The main method of research was the optical coherent tomography. All patients were operated by an original technique. It’s purpose was a closing of earlier operated rigid macular hole using a free flap.Results. The defect of a photoreceptor component was closed with an additional expansion of earlier created macular rexis in patients of the 1st and 3rd groups at reoperation. The earlier created flap of an internal limiting membrane was used in patients of the 2nd group. In the analysis of dependence of change of visual acuity from morphological parameters of a macular hole after primary surgical treatment the inverse correlation relation from diameter of a macular hole on small and big radiuses is revealed. The highest visual acuity after a reoperation was reached at patients of the second group.Conclusions. It is necessary to consider the technique which was used earlier, diameter of a macular hole on small and big radiuses, postoperative edema in a parafovea zone for planning the surgical treatment and a forecast of functional results. 

scholarly journals An algorithm for managing surgical patients with acute retinal necrosis

2018 ◽  
Vol 11 (4) ◽  
pp. 29-35
Author(s):  
V. V. Neroev ◽  
P. A. Ilyukhin ◽  
V. E. Tankovsky ◽  
R. A. Fedotov
Keyword(s):  
Visual Acuity ◽  
Surgical Treatment ◽  
Retinal Detachment ◽  
Comparison Group ◽  
Silicone Oil ◽  
Clinical Manifestations ◽  
Main Group ◽  
Acute Retinal Necrosis ◽  
Surgical Patients ◽  
Irreversible Damage

Purpose. To increase the efficiency of surgical treatment and develop an algorithm for managing patients with the consequences of acute retinal necrosis (ARN).Material and methods. The study included 35 patients (42 eyes) aged 18 to 74 with acute retinal necrosis. All patients underwent a microinvasive (23 Ga) vitrectomy with membrane peel, endolaser coagulation of the retina and endotamponade of the vitreal cavity with silicone oil. The operated eyes were divided into 2 groups. The main group consisted of 17 eyes with a clinical picture of fibrosis of the vitreous without retinal detachment (10 eyes) and retinal detachment without pronounced fibrosis of the vitreous (7 eyes). The comparison group included 25 eyes which had retinal detachment and fibrosis of the vitreous at the time of surgery. The visual acuity varied between incorrect light projection and 0.15 with correction.Results. A stable anatomical and optical result was achieved in all cases. Complete adhesion of the detached retina was achieved in 94.1 %, which is explained by the fact that surgical treatment was in most cases performed in the absence of pronounced stages of proliferative vitreoretinopaty. In all cases of the main group, an increase in visual acuity was noted. In 53 % of cases, visual acuity achieved 0.1 to 0.3 and in the remaining 47 % it was 0.3 % or above. This can be accounted for by the prevalence of peripheral necrotic lesions, as well as a lower incidence of macular edema and optic neuropathy. However, in the comparison group, an increase in visual acuity was only observed in 56 % cases, with visual acuity reaching 0.1 or higher only in 24 % of the eyes. A high frequency (72 %) of necrosis expansion to the posterior eye pole with an irreversible damage to the optic nerve and the macular region was revealed.Conclusion. Active dynamic observation of patients with ARN helps detect changes requiring surgical treatment, which leads to higher functional and anatomical outcomes, as well helps avoid the disability of the patients. Surgical treatment prior to the formation of retinal detachment in severe traction syndrome with or without retinal tears is advisable. An algorithm was proposed for managing surgical patients, depending on the clinical manifestations of ARN effects.

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