The assessment of combined laser and microinvasive surgery efficiency in local retinal detachment treatment

Doga, A.V.; Shkvorchenko, D.O.; Kryl, L.A.; Buryakov, D.A.; Bayzulaeva, M.R.

doi:10.25276/2312-4911-2019-1-363-368

Cited by 2 publications

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“…Данный метод лечения заключается в иссечении зоны витреоретинального сращения (ВРС), ПР и барьерной ЛКС после полного прилегания сетчатки [18,19]. Показана эффективность данного метода, равная 93%, у 15 пациентов (15 глаз) с периодом наблюдения 2 года [20]. Однако небольшой размер выборки в данном исследовании обусловливает необходимость ее дальнейшего изучения.…”

Section: актуальностьunclassified

Long-term outcomes combined minimally invasive laser surgical technique for local rhegmatogenous retinal detachment

Doga¹,

Shkvorchenko²,

Kryl³

et al. 2021

Russian Journal of Clinical Ophthalmology

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Aim: to evaluate the long-term clinical efficacy of the combined (laser plus surgical) minimally invasive technique for rhegmatogenous retinal detachment (RRD). Patients and Methods: treatment results of 41 patients (41 eyes) with local RRD resulting from horseshoe retinal tear were analyzed. All patients underwent wide-field optical coherence tomography (OCT) to localize and measure pathological vitreoretinal adhesions at the site of retinal tear. The next step was a combined laser surgical procedure that included Nd: YAG dissection of pathological vitreoretinal adhesion zone, pneumatic retinopexy (10% C3F8), and barrier laser retinal photocoagulation (LRP) after reattachment. Postoperatively, eye exams were performed after 3 and 7 days, 3, 6, 12, 18, and 24 months. Results: complete reattachment was achieved in 38 patients (92.7%) on day 2 or 3. No reattachment was seen in three patients (7.3%); of them, subretinal gas migration was observed in two patients (4.9%), and partial reattachment was detected in one patient (2.4%) with pseudophakia. Recurrent RRD occurred in 3 patients (7.9%) because of new inferior retinal breaks. In four patients (10.5%), postoperative wide-field OCT of the area of the initial retinal tear performed after reattachment revealed additional pathological vitreoretinal adhesions in the adjacent areas (that were not identified preoperatively). These patients underwent additional LRP around the areas of pathological vitreoretinal adhesions. No recurrent RRDs were seen during follow-up. Conclusion: combined minimally invasive laser surgical technique for local PPDs demonstrated high efficacy (92.7%). This technique was the effective in local retinal detachment resulting from a single superior horseshoe retinal tear in patients with crystalline lens. In some cases, pseudophakia is a technical obstacle to this procedure. Postoperative wide-field OCT is recommended to detect additional pathological vitreoretinal adhesions and to perform LRP around them to reduce the risks of recurrent RRDs greatly. Keywords: rhegmatogenous retinal detachment, optical coherence tomography, Nd: YAG laser retinotomy, vitreoretinal traction. For citation: Doga A.V., Shkvorchenko D.O., Kryl L.A. et al. Long-term outcomes combined minimally invasive laser surgical technique for local rhegmatogenous retinal detachment. Russian Journal of Clinical Ophthalmology. 2021;21(2):63–68. DOI: 10.32364/2311-7729-2021-21-2-63-68.

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Section: актуальностьunclassified

Long-term outcomes combined minimally invasive laser surgical technique for local rhegmatogenous retinal detachment

Doga¹,

Shkvorchenko²,

Kryl³

et al. 2021

Russian Journal of Clinical Ophthalmology

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“…Предложенная технология, помимо своей микроинвазивности и малотравматичности, позволяет устранить основные звенья патогенеза отслойки сетчатки, отвечая, таким образом, всем критериям успешного лечения РОС. Проведённый нами раннее анализ первых клинико-функциональных результатов лечения по представленной методике показал высокую эффективность технологии, равную 93% [13]. Однако необходим дальнейший анализ технологии с оценкой её эффективности и безопасности.…”

Section: Introductionunclassified

Assessment of Efficacy and Safety of Combined Microinvasive Laser-Surgical Treatment of Rhegmatogenous Retinal Detachment

Doga¹,

Shkvorchenko²,

Kry³

et al. 2020

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Objective: To evaluate the efficacy and safety of combined laser-surgical treatment of rhegmatogenous retinal detachment (RRD). Methods: The 32 eyes from 32 patients with a local RRD due to horseshoe tear were enrolled. In addition to standard examination, all patients underwent multispectral laser scanning and wide-field optical coherence tomography (WFOCT) to determine the extention and localization of vitreoretinal tractions (VRT). All patients underwent the combined microinvasive laser-surgical technology of RRD treatment, including YAG-laser excision of the VRT area, pneumatic retinopexy, and barrier laser photocoagulation around the retinal tear after complete retinal attachment (2-3 days). The post-operative examination was performed on days 3 and 7, and in 3, 6, 12, 18, and 24 months. The follow-up period was 2 years. Results: Retinal attachment was achieved in 30 patients (93.8%). The retina did not attach in 2 cases (6.4%) – in a patient with pseudophakia and in a patient who did not follow the recommendations on the proper head position after surgery. The recurrence of retinal detachment occurred in 2 cases (6.7%) as a result of the new tears formation in lower parts of the fundus periphery. The rest of the patients had a stable anatomical and functional result and no recurrence of the disease during the follow-up period. In 2 cases (6.7%) post-operative WFOCT revealed an additional zone of VRT in the adjacent areas to primary retinal tear which could not be visualized when retina was detached. These patients underwent additional barrier laser photocoagulation around revealed areas. No relapses occurred in these patients. Clinically insignificant retinal bleeding was observed in 4 cases (12.5%) during combined laser angiotomy. Full haemostasis was achieved by the 3-mirror contact lens pressure on the eye. Conclusions: The presented technology demonstrates efficiency in 93.8% of cases after a single surgical intervention. The advantage of the technology is the complete elimination of VRT, as the main factor of the disease pathogenesis, which increases the anatomical efficacy of surgery and reduces the risk of recurrence. The micro-invasiveness and low trauma of this type of treatment help to minimize complications and accelerate the rehabilitation of patients. Further study of this technology with a large number of patients and a long follow-up period is required. Keywords: Rhegmatogenous retinal detachment, wide-field optical coherence tomography, vitreoretinal traction, YAG-laser retinotomy, pneumatic retinopexy, barrier laser photocoagulation.

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The assessment of combined laser and microinvasive surgery efficiency in local retinal detachment treatment

Cited by 2 publications

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Long-term outcomes combined minimally invasive laser surgical technique for local rhegmatogenous retinal detachment

Long-term outcomes combined minimally invasive laser surgical technique for local rhegmatogenous retinal detachment

Assessment of Efficacy and Safety of Combined Microinvasive Laser-Surgical Treatment of Rhegmatogenous Retinal Detachment

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