The use of autologous conditioned plasma (ACP) in the surgical treatment of full-thikness macular holes

2021 ◽  
pp. 102-105
Author(s):  
I.V. Laskova ◽  
◽  
A.A. Kravchenko ◽  
D.I. Uskov ◽  
E.V. Lopina ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Macular Hole ◽  
High Efficiency ◽  
Silicone Oil ◽  
Pigment Epithelium ◽  
Subretinal Fluid ◽  
Ophthalmological Examination ◽  
Ophthalmic Surgery ◽  
Macular Holes ◽  
Number Of Patients

Increasingly, the use of autologous conditioned plasma in ophthalmic surgery in recent years has been given more preference than other blood products with similar effects. Surgical treatment of full-thikness macular hole is no exception. Domestic and foreign studies of recent years show that the use of ACP as an adhesive component in the treatment of this pathology is considered the most acceptable. However, in addition to the effective "gluing" of the macular hole, the convergence of its edges plays an important role in the postoperative anatomy of the foveolar zone. Objective: to study the effectiveness of the use of autologous conditioned plasma in the surgical treatment of full-thikness macular hole. Materials and methods of research. Patients who underwent surgery for a full-thikness macular hole with a diameter of more than 400 microns were prospectively observed. The study included 51 patients. The follow-up period ranged from 2 months to 1 year. All patients in the preoperative and postoperative periods underwent a comprehensive ophthalmological examination. Surgical technique: after a standard three-port vitrectomy (25Ga), the posterior hyaloid membrane was removed, and the ILM was peeled. With the help of a saline solution, a circular separation of the bonds between the edges of the gap and the pigment epithelium was achieved. After the subretinal fluid was removed and the induced local central retinal detachment was attached, the tear area was irrigated by ACP. After that, the air was replaced with silicone oil, which was removed after 1.5 months. Nodal sutures were applied to the sclerotomy (vicryl 8-0). Results. In 49 operated patients, anatomical restoration of the foveolar zone was achieved, which accounted for 96% of the total number of patients. Visual functions were evaluated after 1.5 months (after removal of silicone oil). Corrected visual acuity in 96% of patients ranged from 0.2 to 0.5. Conclusion. The high efficiency of the use of autologous conditioned plasma in the treatment of full-thikness macular holes allows us to achieve high anatomical and functional results. Key words: macular rupture, autologous conditioned plasma, silicone tamponade.

Analysis of results of inverted internal limiting membrane flap technique using 3D visualization for surgical treatment of macular holes

2021 ◽  
pp. 31-35
Author(s):  
A.V. Egorov ◽  
◽  
O.V. Kolenko ◽  
A.Y. Khudyakov ◽  
V.V. Egorov ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Surgical Treatment ◽  
High Efficiency ◽  
Silicone Oil ◽  
3D Visualization ◽  
Internal Limiting Membrane ◽  
Visualization System ◽  
Flap Technique ◽  
Macular Holes ◽  
Analysis Of Results

Purpose. Analysis of results of inverted internal limiting membrane (ILM) flap technique using 3D visualization for surgical treatment of macular holes (MH). Material and methods. 21 people with stage 3 or 4 MH. Visometry and optical coherence tomography (OCT) were performed before surgery, on the 3rd day and 1 month after surgery. All patients underwent a three-port 27G vitrectomy with using NGENUITY 3D visualization system (Alcon, USA). After vitrectomy and ILM staining, the ILM flap was formed in the form of single monoblock with wide base, which was turned over and placed on the MH area. The operation was completed by fluid/air exchange. Results. MH closure on the 3rd day after surgery was observed in 19 (90.5%) of 21 patients. In 2 patients, MH closure was absent; in these cases, a second operation was performed with silicone oil tamponade. One month after the operation, according to OCT datas, complete MH closure was noted in all patients. The average value of the best corrected visual acuity by this observation period was 0.3, which was 6 times higher than the initial (0.05) visual acuity. The use of 3D visualization system allowed us to reduce the level of endoillumination by up to 15% and to reduce the exposure time of the endovitreal dye to 15 seconds to reduce the risks of retinal phototoxicity. Conclusion. The proposed inverted ILM flap technique made it possible to achieve MH closure in 90.5% of cases. The experience of using NGENUITY 3D visualization system has shown high efficiency and safety by reducing the risk of iatrogenic phototoxicity. Key words: macular hole, inverted flap, internal limiting membrane, 3D visualization, NGENUITY.

Extrascleral Filling Using Endoillumination the First Experiencethe

2020 ◽  
pp. 43-49
Author(s):  
V.Y. Markevich ◽  
◽  
T.A. Imshenetskaya ◽  
O.A. Yarmak ◽  
◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Retinal Detachment ◽  
Rhegmatogenous Retinal Detachment ◽  
Silicone Oil ◽  
Subretinal Fluid ◽  
Crystalline Lens ◽  
Vitreous Cavity ◽  
Macular Area ◽  
General Group ◽  
Anatomical Outcome

Purpose. To study the effectiveness of extrascleral filling (ESF) using endoillumination in the surgical treatment of patients with primary rhegmatogenous retinal detachment (RRD). Material and methods. The material for the study was the data of a comprehensive clinical examination and surgical treatment by ESF method using endoillumination in 17 patients (17 eyes) with RRD. In 7 cases (41%), the macular area was involved in the detachment process. In 5 cases (29.4%), local scleral filling was performed. In the remaining 12 cases (70.6%), the local ESF was supplemented with a circling silicone element. Surgical intervention was supplemented by transscleral drainage of subretinal fluid (SRF) in 10 cases (59%) and pneumatic retinopexy with SF6 gas 50% in 8 cases (48%). Results. In the general group of patients, best corrected visual acuity (BCVA) increased from 0.35 to 0.46. In the subgroup of patients with a detached macular area, the positive dynamics is more pronounced, BCVA increased from 0.1 to 0.28. The progression of proliferative vitreoretinopathy caused the recurrence of retinal detachment in two patients (11.8%). Recurrences were diagnosed after 3 and 5 months, respectively. In both cases, a vitrectomy with tamponade of the vitreous cavity with silicone oil 5000 Cst was performed. The percentage of successful anatomical outcome after the first operation in our study was 82%. The percentage of successful achievement of the final anatomical result was 94%. In two cases, additional injection of SF6 gas into the vitreous cavity was required. Conclusion. This type of surgical treatment is an effective method of surgical treatment of patients with RRD. In our study, the successful anatomical outcome after the first operation was recorded in 82% of patients, which correlates with the data of the authors who also used this method (83–92%). Surgeons who performed surgical treatment using this technique in our study note improved workplace ergonomics when visualizing the fundus using an operating microscope and endoillumination compared with indirect ophthalmoscopy. Other teams of authors came to this conclusion as well. In our study, there were no complications associated with the introduction of a light pipe into the vitreous cavity (iatrogenic crystalline lens injury, endophthalmitis), which indicates the safety of this type of surgical treatment.

Postoperative endophthalmitis

2021 ◽  
pp. 185-187
Author(s):  
I.A. Frolychev ◽  
◽  
N.A. Pozdeyeva ◽  
◽  
◽  
...  
Keyword(s):  
Visual Acuity ◽  
Surgical Treatment ◽  
Silicone Oil ◽  
Angiogenesis Inhibitor ◽  
Cataract Extraction ◽  
State Institution ◽  
Federal State ◽  
Postoperative Endophthalmitis ◽  
Ophthalmic Surgery ◽  
Corrected Visual Acuity

Surgical treatment of postoperative endophthalmitis is an urgent problem of ophthalmic surgery. Purpose.The aim of the study was to analyze the results of treatment of patients with postoperative endophthalmitis using perfluorodecalin and antibiotic solutions for vitreal cavity tamponade. Materials and methods. For the period 2016-2020, 35 patients (35 eyes) were operated in the Cheboksary branch of the S. Fyodorov Eye Microsurgery Federal State Institution. In 26 patients, this complication occurred after cataract extraction, in 7 after vitreoretinal operations, in 2 after intravitreal administration of an angiogenesis inhibitor. Visual acuity before treatment of endophthalmitis in 3 patients was to 0.02– 0.08, in 16 – counting of fingers in the face, in 13 – pr.l.certa, in 3-pr. l. incerta. All patients underwent vitrectomy with perfluorodecalin tamponade of the vitreal cavity for up to 14 days and intravitreal administration of vancomycin 1 mg and ceftazidime 2.25 mg at the end of the operation. On day 2-3, all patients underwent additional intravitreal administration of antibiotics, depending on the detected pathogen. Further, in 22 patients, the removal of perfluorodecalin and the remaining preretinal and peripherally located exudate was performed, in 13 patients - tamponade of the vitreal cavity with silicone oil. Results. As a result of the treatment according to the developed method, it was possible to preserve visual functions in 32 patients (91%) out of 35. At discharge, the corrected visual acuity was from 0.1 to 0.7 (0.28±0.2). After 6 months, the corrected visual acuity in 32 patients was from 0.1 to 0.9 (0.36±0.2). Visual acuity (above 0.3) was achieved in 26 cases (74.3%). Conclusion. Clinical results demonstrate the effectiveness of the developed method of surgical treatment of endophthalmitis. Key words: postoperative endophthalmitis, perfluorodecalin, intravitreal administration of vancomycin and ceftazidime.

scholarly journals Optical Coherence Tomography Findings in Idiopathic Macular Holes

2011 ◽  
Vol 2011 ◽  
pp. 1-4 ◽  
Author(s):  
Lynn L. Huang ◽  
David H. Levinson ◽  
Jonathan P. Levine ◽  
Umar Mian ◽  
Irena Tsui
Keyword(s):  
Optical Coherence Tomography ◽  
Macular Hole ◽  
Clinical Assessment ◽  
Chart Review ◽  
Subretinal Fluid ◽  
Optical Coherence ◽  
Cross Sectional ◽  
Macular Holes ◽  
Idiopathic Macular Holes ◽  
Intraretinal Cysts

Purpose. To describe the characteristics of idiopathic macular holes (MH) on optical coherence tomography (OCT) and correlate OCT with clinical assessment.Design. Cross-sectional chart review and OCT assessment.Participants. Sixty-seven eyes with a clinically diagnosed idiopathic MH with available OCT data.Methods. A retrospective chart review and OCT assessment.Results. Based on OCT grading, 40 eyes had a full-thickness macular hole (FTMH) and 21 eyes had a lamellar macular hole (LMH). Clinical exam and OCT assessment agreed in 53 (87%) eyes when assessing the extent of MH. Six eyes (14.6%) in the FTMH group, and 3 eyes in the LMH group (14.3%) had persistent vitreomacular traction. Thirty-seven eyes (92.5%) in the FTMH group and 11 eyes (52.4%) in the LMH group had associated intraretinal cysts. Two eyes (5.0%) in the FTMH group and zero eyes in the LMH group had subretinal fluid. Intraretinal cysts were found to be more frequently associated with FTMH than with LMH (P<0.001).Conclusion. This paper described OCT findings in a group of patients with clinically diagnosed MH. A high level of correlation between clinical assessment and OCT findings of LMH and FTMH was observed, and intraretinal cysts were often present in FTMH.

Morphofunctional analysis of the retina in the surgical treatment of idiopathic macular holes

2021 ◽  
pp. 48-52
Author(s):  
A.S. Zotov ◽  
◽  
A.S. Balalin ◽  
S.V. Balalin ◽  
S.M. Purshak ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Surgical Treatment ◽  
Macular Hole ◽  
Practical Importance ◽  
Functional Results ◽  
Hole Diameter ◽  
Optical Coherence ◽  
Macular Holes ◽  
Idiopathic Macular Holes ◽  
Morphofunctional Analysis

Purpose. To evaluate the role of microperimetry and optical coherence tomography (OCT) in the morphofunctional analysis of the retina after surgical treatment of idiopathic macular holes (IMH). Materials and methods. A retrospective study of 33 patient's treatment results (33 eyes) with IMH was carried out. All patients underwent minimally invasive with 25G or 27G vitrectomy. Best corrected visual acuity (BCVA), macular photosensitivity, fixation stability, macular neuroepithelial (NE) volume and minimal macular hole diameter were analyzed. Follow-up period: 6 months. Results. A complete closure of the macular hole was achieved in all cases post-op. The patients had reliable improvement of BCVA, retinal photosensitivity and decrease of macular NE volume. Based on a multifactor correlation analysis with the purpose to predict the results of surgical treatment, the dependence of post-op BCVA on the pre-op photosensitivity of the retina and the minimal diameter of the macular hole was revealed. Conclusions. Microperimetry and OCT are modern non-invasive research methods allowing to estimate anatomical and functional results of surgical IMH treatment. The study of retinal photosensitivity in the macula and minimal macular hole diameter pre-op allows to predict post-op BCVA, which has a practical importance. Keywords: idiopathic macular hole, vitrectomy, microperimetry, optical coherence tomography.

scholarly journals A Female Case of X-Linked Retinoschisis with Macular Hole Bilaterally

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
A. Altun
Keyword(s):  
Visual Acuity ◽  
Macular Hole ◽  
Pars Plana Vitrectomy ◽  
Silicone Oil ◽  
Surgical Experience ◽  
Flap Technique ◽  
Macular Holes ◽  
Female Case ◽  
Pars Plana

Purpose. We aimed at reminding that X-linked retinoschisis may also be seen in female patients and share our vitreoretinal surgical experience. Methods. The patient underwent pars plana vitrectomy including the closure of the macular holes with inverted ILM flap technique bilaterally. Lens extractions were performed by phacoemulsification during the removal of silicone oil endotamponade. Patient. An 18-year-old girl with X-linked retinoschisis and large macular holes in both eyes presented to the clinic of ophthalmology. It was confirmed that the patient had RS1 mutation Results. Nine-month-follow-up was uneventful for retinal findings. Significant improvement in visual acuity was achieved, and macular holes were remained closed. Conclusion. In cases with large macular holes due to XLR, an inverted ILM flap technique might be safe and effective. Four-month-silicone-endotamponade might be sufficient.

scholarly journals Spontaneous Closure of the Macular Hole in a Patient with Acquired Vitelliform Lesion

2020 ◽  
Vol 11 (1) ◽  
pp. 16-21
Author(s):  
Masanori Fukumoto ◽  
Shou Oosuka ◽  
Takaki Sato ◽  
Teruyo Kida ◽  
Tsunehiko Ikeda
Keyword(s):  
Retinal Detachment ◽  
Macular Hole ◽  
Rare Case ◽  
Pigment Epithelium ◽  
Retinal Pigment ◽  
Serous Retinal Detachment ◽  
Subretinal Fluid ◽  
Spontaneous Closure ◽  
Retinal Reattachment

In this paper, we report an extremely rare case of spontaneous closure of a macular hole (MH) that developed in a patient in whom acquired vitelliform lesion (AVL) occurred after vitrectomy for atopic retinal detachment (ARD). A 32-year-old male developed ARD in both eyes, and retinal reattachment was achieved after vitrectomy. Five years after surgery, optical coherence tomography showed localized serous retinal detachment (SRD) and a granular lesion with a higher brightness in the subretinal fluid, thus leading to the diagnosis of AVL. One month later, an MH developed, and a follow-up examination performed 6 weeks later revealed that the MH had spontaneously closed and the SRD decreased. In the fovea, fluorescein angiography revealed a window defect due to atrophy of the retinal pigment epithelium (RPE). These findings in this present case suggest the possibility that RPE dysfunction was involved in the development of AVL and MH.

Gliotic tissue simulating a macular neovascularization in full-thickness macular hole

2021 ◽  
pp. 112067212110295
Author(s):  
Chiara Vigano’ ◽  
Enrico Borrelli ◽  
Riccardo Sacconi ◽  
Maria Brambati ◽  
Francesco Bandello ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Retinal Pigment Epithelium ◽  
Macular Hole ◽  
Male Patient ◽  
Vascular Tissue ◽  
Pigment Epithelium ◽  
Retinal Pigment ◽  
Full Thickness ◽  
Macular Holes ◽  
Full Thickness Macular Hole

The authors report a case of a male patient affected by macular hole. In particular, a hyperreflective tissue was found on optical coherence tomography (OCT) examination in macular region, just above the retinal pigment epithelium (RPE). OCT angiography (OCTA) did not show the presence of vascular tissue, thus the hyperreflective material was ascribed to primary gliotic tissue. This case highlights the ability for Müller cells placed near macular holes to migrate up to the RPE and to produce gliotic tissue.

scholarly journals Exhibiting Residual Subretinal Fluid after High Myopic Macular Hole Retinal Detachment Surgery

2021 ◽  
Vol 62 (12) ◽  
pp. 1672-1678
Author(s):  
Sung Joon Kim ◽  
Jae Jung Lee ◽  
Ik Soo Byon ◽  
Ji Eun Lee ◽  
Sung Who Park
Keyword(s):  
Retinal Detachment ◽  
Macular Hole ◽  
Silicone Oil ◽  
Subretinal Fluid ◽  
Internal Limiting Membrane ◽  
Closure Rate ◽  
Visual Prognosis ◽  
Membrane Peeling ◽  
Macular Hole Retinal Detachment ◽  
The Right

Purpose: To report a case of poor visual prognosis complicated by residual subretinal fluid after use of the internal limiting membrane flap technique to treat macular hole retinal detachment in a patient with high myopia.Case summary: A 55-year-old male stated that he had experienced a transparent circle in the central visual field of the right eye for 1 month. His best-corrected visual acuity (BCVA) was 0.32 and the axial length of the right eye was 32.57 mm. Fundus examination revealed a macular hole with retinal detachment localized to the posterior pole. We performed vitrectomy, membrane peeling, internal limiting membrane peeling with inverted internal limiting membrane flap, and silicone oil injection. On day 1 after surgery, the macular hole was closed, but subretinal fluid was noticed in the macula. At 3 months after surgery, the BCVA was 0.16 and the silicone oil was removed. At 14 months after the first surgery, the subretinal fluid was completely absorbed, but leopard-pattern pigment degeneration became prominent and the macula exhibited ellipsoid zone disruption. The BCVA decreased to 0.1.Conclusions: In patients exhibiting macular hole retinal detachment in the context of high myopia, an inverted internal limiting membrane flap may increase the macular hole closure rate but disturb subretinal fluid drainage. As persistent subretinal fluid may cause permanent retinal damage with a poor visual prognosis, the surgical method must be carefully chosen.

scholarly journals Unrecognized Orbital Images Cause Diagnostic Confusion: Silicone Oil and Implanted Silicone Encircling Bands

2021 ◽  
Vol 2021 ◽  
pp. 1-3
Author(s):  
Tsuyoshi Nojima ◽  
Takafumi Obara ◽  
Kohei Tsukahara ◽  
Atsunori Nakao ◽  
Hiromichi Naito
Keyword(s):  
Case Report ◽  
Retinal Detachment ◽  
Head Trauma ◽  
Silicone Oil ◽  
Ophthalmological Examination ◽  
Ophthalmic Surgery ◽  
High Attenuation ◽  
Postoperative Changes ◽  
Imaging Characteristics ◽  
Diagnostic Confusion

Introduction. Most physicians are not familiar with postoperative changes to the orbit, so radiologists and clinicians may sometimes find it challenging to conduct a proper radiological assessment of the globe of the eye and orbital abnormalities. We present a patient with head trauma who had surgery for retinal detachment with implantation of silicone encircling bands. This case report may help clinicians recognize imaging characteristics after ophthalmic surgery to prevent misdiagnosis and unnecessary workup. Case Report. An 18-year-old man with severe head trauma was admitted to our hospital. Initial computed tomography (CT) revealed a high attenuation of intraocular silicone that could be mistaken for a hemorrhage. Ophthalmological examination and detailed ophthalmic history confirmed silicone oil in his eye for treatment of retinal detachment. Knowledge of the anatomical changes and radiological appearance of postsurgical findings following retinal detachment, including the surgical materials of silicone oil or bands, can prevent unnecessary alarm. Conclusion. Implanted ophthalmic devices, for example, silicone oil, appear similar to hemorrhages on CT and magnetic resonance imaging and cause diagnostic confusion. When in doubt, it is useful to assess the clinical presentation and obtain an accurate medical history.

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