HFEW represents a novel technique for retinopexy during vitreoretinal surgery. It allows firm chorioretinal adhesion immediately after exposure. In non-vitrectomized eyes, using 14-16 V is particularly effective.
BackgroundThe literature is scant on the state of the ciliary body, its role in the development of rhegmatogenous retinal detachment (RRD) complicated by choroidal detachment (CD), and on ciliary body changes following the treatment aimed at resolving concomitant inflammation and choroidal attachment. This study assesses the anatomical position and thickness of the ciliary body and investigates the ciliary body changes after anti-inflammatory pre-vitrectomy treatment in RRD complicated by CD.MethodsForty-nine patients (49 eyes) with RRD complicated by CD underwent standard ophthalmological examination (including visual acuity assessment, biomicroscopy, ophthalmoscopy, and ocular tonometry) and ultrasound biomicroscopy of the ciliary body, choroid, and retina both before and following anti-inflammatory pre-vitrectomy treatment.ResultsAt baseline, all subject eyes had ciliary body edema and detachment extending into the choroid. Ultrasonographic ciliary features included ciliary body edema and disorganization of the supraciliary layer of the pars plana, which was evident by the presence of multiple small oblique fibers. In all subject eyes, the treatment resulted in reattachment of the choroid and the ciliary body as well as a reduction in ciliary body edema (total mean ciliary thickness reduced from 0.83 (0.09) to 0.65 (0.09) mm, with a difference of 0.18 (0.07) mm, P < 0.001).ConclusionsPreoperative anti-inflammatory treatment in RRD complicated by CD results in restoration of the anatomical position of the ciliary body and a statistically significant reduction in ciliary body edema.
Intravitreal aflibercept resulted in the obliteration of neovascularization of epiretinal membranes, thus avoiding intraoperative and postoperative bleeding during vitrectomy. The improvement in visual acuity was noted in all cases. Histologic examination of epiretinal membranes determined single-thin-walled capillary vessels lined with endothelial cells without blood cells.
Purpose: to evaluate the morphological changes in eye tissue after the influence of high‐frequency electric current welding (HFECW) with suprachoroidal approach in rabbit's eyes in order to induce chorio‐retinal adhesion as an alternative treatment for retinal tears.
Methods: 54 adult rabbits were used. The study complied to the ARVO statement for use of animals in ophthalmic and visual research. In the treated group, the retina was coagulated 7–10 mm from the limbus through a U‐shaped scleral incision with suprachoroidal approach using 23‐gauge tip and modified HFECW generator EK‐300 M1 (E.O. Paton Electric Welding Institute, Kyiv, Ukraine) with parameters: 66 kHz HFECW, three modes of 10–12 Volts (V), 12–14 V and 14–16 V. The eyes were then enucleated after 1 hour and 3‐, 7‐, 14‐ and 30‐days. Tissue changes were analysed using haematoxylin–eosin staining and light microscopy, and compared to the control eyes.
Results: In all treated eyes the monopolar HFECW induced an increased tissue adhesion in the area of electrode application, which strengthened with time. The retina responded by apparent destruction of rods, cones, loss of bipolar, amacrine, horizontal and ganglion cells, development of cysts and migration of RPEs. The choroid showed damage and migration of melanocytes. By 30 days, a tissue thinning with partial cell regeneration and connective tissue degeneration were apparent. Amplification of the voltage from 10 to 16 V caused a shift from active exudation without significant tissue damage to acute retinal necrosis, respectively. The nearby lying retinal layers and vitreous remained intact.
Conclusions: Application of HFECW with suprachoroidal approach induced chorio‐retinal adhesion in 1 hour after the treatment, which strengthened within first weeks after the surgery. Implementation of HFECW as an alternative method to treat retinal tears in eyes with retinal detachment could reduce the need for endotamponade and the risks of its possible complications.
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