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.

Optimized approach to surgical treatment of proliferative diabetic retinopathy in patients with permanent hemodialysis

2021 ◽  
pp. 26-30
Author(s):  
A.S. Golovin ◽  
◽  
O.A. Sinyavskiy ◽  
R.L. Troyanovsky ◽  
◽  
...  
Keyword(s):  
Visual Acuity ◽  
Diabetic Retinopathy ◽  
Surgical Treatment ◽  
Key Words ◽  
Intravitreal Injection ◽  
Proliferative Diabetic Retinopathy ◽  
Visual Functions ◽  
Hemodialysis Session ◽  
Anti Vegf ◽  
Optimal Approach

Purpose. Optimization and identification of key conditions for successful surgical treatment of PDR in patients with permanent hemodialysis. Material and methods. The results of surgical treatment of 8 patients (10 eyes) with PDR who received permanent hemodialysis were analyzed. All patients underwent surgery 18-20 hours after the hemodialysis session. 25G vitrectomy with phacoemulsification 1-5 days after intravitreal injection inhibitor of anti-VEGF. Results. In 9 cases, an improvement in visual functions was achieved. Visual acuity of 0.08-0.1 in 5 cases, 0.1-0.2 in 3 cases and 0.3 in one case on a single eye. Conclusions. The described stereotype is the optimal approach for the surgical treatment of PDR in patients with permanent hemodialysis. Key words: proliferative diabetic retinopathy, hemodialysis, vitrectomy.

Treatment Patterns and Clinical Outcomes for Branch Retinal Vein Occlusion: An 8-Year Experience at a Tertiary Eye Center

2021 ◽  
pp. 247412642097887
Author(s):  
Terry Lee ◽  
Cason B. Robbins ◽  
Akshay S. Thomas ◽  
Sharon Fekrat
Keyword(s):  
Visual Acuity ◽  
Diabetic Retinopathy ◽  
Retinal Vein Occlusion ◽  
Real World ◽  
Early Treatment ◽  
Branch Retinal Vein Occlusion ◽  
Treatment Patterns ◽  
Vein Occlusion ◽  
Anti Vegf ◽  
Treatment Naïve

Purpose: This work aims to investigate real-world treatment patterns and outcomes in eyes with branch retinal vein occlusion in the antivascular endothelial growth factor (anti-VEGF) era. Methods: A retrospective, nonrandomized, comparative study was conducted on eyes diagnosed with branch retinal vein occlusion at a single tertiary center between 2009 and 2017. Medical history, treatment patterns, and visual acuity outcomes were examined. Subanalysis was performed for eyes that met the eligibility criteria for the BRAVO (Ranibizumab for the Treatment of Macular Edema Following Branch Retinal Vein Occlusion) trial. Results: A total of 315 eyes were included, of which 244 were treatment naive. In all eyes, the most common first treatment was the following: intravitreal bevacizumab (38.4%), aflibercept (15.1%), ranibizumab (8.1%), sectoral scatter laser (6.2%), and triamcinolone (3.1%). At 1 year, treatment-naive eyes had received an average of 2.43 anti-VEGF injections. During follow-up, treatment-naive eyes gained an average of 0.21 Early Treatment Diabetic Retinopathy Study lines. Forty eyes that met BRAVO trial criteria received an average of 5.05 anti-VEGF injections in the first year and gained an average of 1.83 Early Treatment Diabetic Retinopathy Study lines. Conclusions: This real-world cohort received fewer anti-VEGF injections at year 1 and experienced less improvement in visual acuity during the course of treatment than clinical trial participants. Trial-eligible patients received more injections and had greater visual gains than those who would not have been eligible for the trial.

scholarly journals A Systematic Review and Meta-Analysis of Clinical Outcomes of Intravitreal Anti-VEGF Agent Treatment Immediately after Cataract Surgery for Patients with Diabetic Retinopathy

2019 ◽  
Vol 2019 ◽  
pp. 1-10 ◽  
Author(s):  
Li-Quan Zhao ◽  
Jin-Wei Cheng
Keyword(s):  
Visual Acuity ◽  
Diabetic Retinopathy ◽  
Treatment Group ◽  
Cataract Surgery ◽  
Comparative Studies ◽  
Group Analysis ◽  
Control Group ◽  
Anti Vegf ◽  
The Mean ◽  
Agent Treatment

Aims. To examine possible benefits of intravitreal anti-vascular endothelial growth factor (VEGF) agent treatment immediately after cataract surgery for patients with diabetic retinopathy (DR). Methods. A comprehensive literature search was performed using the Cochrane collaboration methodology to identify randomized controlled trials (RCTs) and comparative studies of cataract surgery with or without anti-VEGF agent treatment for any diabetic retinopathy. Meta-analyses were performed for clinical outcome parameters including changes in macular thickness (MT), best-corrected visual acuity (BCVA), incidence of diabetic retinopathy and maculopathy progression, laser treatment rate, and other complications. Results. Nine RCTs and 3 nonrandomized comparative studies were identified and used for comparing cataract surgery with intravitreal bevacizumab (IVB) or intravitreal ranibizumab (IVR) treatment (338 eyes, intervention group) to cataract surgery alone (329 eyes, control group). Analysis of all data showed that the mean BCVA at 1 week postoperatively had no statistically significant difference in the two groups, but at 1, 3, and 6 months postoperatively, the mean BCVA was statistically significantly better in the anti-VEGF treatment group than that in cataract surgery alone group. Analysis of all data showed that the mean MT was statistically significantly less in the anti-VEGF treatment group at 1 week and 1, 3, and 6 months postoperatively (P=0.05, P=0.006, P=0.0001, and P=0.0001, respectively); but postoperative clinical outcomes were differentiated from the type of anti-VEGF agents, IVB or IVR, and the existing macular edema preoperatively. Intravitreal anti-VEGF agent treatment statistically significantly reduced the incidence of diabetic retinopathy progression and maculopathy progression compared to the control group (P=0.0003, P<0.00001, respectively). Conclusion. IVB or IVR treatment immediately after cataract surgery may represent a safe and effective strategy to prevent postoperative macular thickening or reduce macular edema and result in greater mean improvements in visual acuity for diabetic patients.

scholarly journals Use of Autologous Conditioned Platelet Rich Plasma in the Surgery of Rhegmatogenous Retinal Detachment with Central and Peripheral Tears

2019 ◽  
Vol 4 (4) ◽  
pp. 61-65
Author(s):  
D. G. Arsiutov
Keyword(s):  
Visual Acuity ◽  
Retinal Detachment ◽  
Postoperative Period ◽  
Rhegmatogenous Retinal Detachment ◽  
Silicone Oil ◽  
Platelet Rich Plasma ◽  
Dentate Line ◽  
Retinal Tears ◽  
Retinal Reattachment ◽  
Late Postoperative Period

Background. The method of the use of autologous conditioned platelet rich plasma is a promising method in the surgery of retinal pathology, particularly in the surgery of rhegmatogenous retinal detachment without the use of additional endolaser photocoagulation, but requires the foundation of its efficiency.Aim: to evaluate the effectiveness of the surgery of rhegmatogenous retinal detachment with central (macular) and peripheral retinal tears, including retinal abruption from the dentate line, with the use of 25, 27-gauge subtotal vitrectomy, pneumoretinopexy and silicone oil tamponade with blocking of retinal defect with the use of autologous conditioned plasma without the use of endolaser photocoagulation around retinal defects.Materials and methods. The surgery included 25, 27-gauge vitrectomy, posterior hyaloid membrane removal, internal limiting membrane removal in case of macular hole, pneumoretinopexy, instiilation in 2–3 layers of autologous conditioned platelet rich plasma, devoid of leukocytes and containing 1.5–3 times more thrombocytes than in whole blood into the area of retinal detachment or along the edge of retinotomy till the retinal defect and nearby intact retina are totally covered. A total of 29 patients with visual acuity from 0.03 to 1.0 underwent the surgery.Results. In the early postoperative period (up to 1 month) 96.6 % of patients showed total retinal reattachment, retinal detachment was blocked, in one patient with multiple retinal tears recurrent retinal detachment was detected; in the early delayed postoperative period (1–3 months) 82.8 % of patients showed total retinal reattachment, in 5 patient retinal reattachment was partial.In the late postoperative period (4–12 months) 86.2 % of patients showed total retinal reattachment, there were 4 recurrent retinal detachments. Patients with recurrent retinal detachment were successfully reoperated. Autologous conditioned plasma was not used during reoperations. Visual acuity of the patients, which underwent surgery in the late postoperative period, was 0.1–1.0.Conclusions. 25, 27-gauge vitreoretinal surgery of rhegmatogenous retinal detachment with central and peripheral retinal tears, including tears with abruption from the dentate line and retinal defects blocking with the use of autologous conditioned plasma rich with thrombocytes without the use of endolaser photocoagulation around retinal defects – is a method which allows to achieve in most cases total retinal reattachment, better functioning of the operated eye.

scholarly journals CHANGE IN THE QUALITY OF LIFE OF CHILDREN AFTER SURGICAL TREATMENT OF RETINAL DETACHMENT

2018 ◽  
Vol 25 (6) ◽  
pp. 149-153
Author(s):  
A. N. Sergienko ◽  
V. V. Dashina ◽  
A. V. Malyshev ◽  
O. I. Lysenko ◽  
S. V. Yanchenko
Keyword(s):  
Quality Of Life ◽  
Statistical Analysis ◽  
Surgical Treatment ◽  
Retinal Detachment ◽  
Postoperative Period ◽  
Control Group ◽  
Russian Version ◽  
Group I ◽  
Group Ii

Aim.The study was designed for the evaluation of the quality of life of children with retinal detachment during vitrectomy.Materials and methods. 23 children with retinal detachment aged from 10 to 17 years were treated. Surgical treatment consisted of a three-port vitrectomy and a laser endocoagulation of the retina. 3 groups were formed with the help of a random sampling. During the surgical treatment of group I (n=8), only balanced non-oxidant solutions of salts (Balsed Salt Solution − BSS) were used. Tablets of antioxidant preparations were not assigned. Saline solutions with antioxidants (BSS plus) were used to carry out surgery for group II (n=8). Group III (n=7) was additionally taking antioxidant preparations peros for 3 months in the postoperative period . The quality of life was studied using the abridged Russian version of the VFQ-25 questionnaire. 10 children of the same age with no indications of surgical treatment of retinal detachment were selected for the control group. Statistical analysis of the obtained data was carried out using a set of programs for applied statistical analysis Analyst Soft, Bio Stat 2007.Results.A week after the surgical treatment, no increase in visometric data was observed. Six months later, a significant increase in visual acuity was revealed. The highest visometric data were observed in group II due to the minimal progression of lens opacities. Group I patients had the lowest values of this index.Conclusion.The positive effect of the surgical treatment of retinal detachment positively influenced the patients’ quality of life in the early and late postoperative period.

The experience of using platelet-rich plasma (PRP) in surgery of rhegmatogenous retinal detachment

2021 ◽  
pp. 53-56
Author(s):  
S.V. Ivanov ◽  
◽  
V.S. Samartsev ◽  
P.F. Ivanova ◽  
◽  
...  
Keyword(s):  
Visual Acuity ◽  
Retinal Detachment ◽  
Key Words ◽  
Postoperative Period ◽  
Rhegmatogenous Retinal Detachment ◽  
Platelet Rich Plasma ◽  
Vitreous Body ◽  
Economic Losses ◽  
Air Tamponade ◽  
Retinal Adhesion

Purpose. To evaluate the effectiveness of using platelet-rich plasma (PRP) as a blocking of retinal rupture without the use of silicone and gas tamponade (SF6, C2F6, C3F8). Material and methods. In the period from September 2020 to February 2021, in the conditions of the BUZ UR "Republican Ophthalmological Clinical Hospital" of the Ministry of Health of the Udmurt Republic, 12 patients aged 48 to 70 years were treated with a diagnosis of rhegmatogenous retinal detachment with the presence of peripheral tears. In 12 patients, breaks of different localization were revealed - in eight, in the upper half, in four in the lower half of the retina. Myopia was identified as a risk factor in 6 patients. Visual acuity before surgery ranged from 0.001 to 0.3. The operations were performed under retrobulbar anesthesia. In all cases, a subtotal 25Ga vitrectomy was performed with the removal of the posterior hyaloid membrane (PCM) to the extreme periphery and careful excision of the vitreous body in the area of retinal ruptures. The next stage is the introduction of PFOS to the level of the retinal defect, replacing it with air and draining the SRF, minimal endolaser coagulation of the retina around the retinal ruptures. At the final stage of the operation, platelet-enriched plasma was sequentially multi-layered on the rupture area until the rupture was blocked with a PRP layer. In all patients, the operation was completed with air endotamponade. Results. On the first day, visualization of the fundus was reduced in all patients due to air tamponade. By the 4th day, plasma enriched with platelets in the form of a gray film was determined on the surface of the retina in the zone of rupture, the resorption of which occurred within 2 weeks. The duration of the air tamponade averaged 7-10 days. Retinal adhesion in the early postoperative period was achieved in all patients. In 6 patients with the introduction of PRP, a picture of mild uveitis was observed, which was stopped within 1-3 days against the background of anti-inflammatory treatment. No other complications were observed. In the late postoperative period (after 2 weeks), complete retinal adhesion was maintained in 12 patients, visual acuity was 0.05-0.2. According to the data of the performed echography, phosphene and the study of the visual fields, no pathological changes were revealed. In the long-term postoperative period, complete retinal adhesion was noted in 10 patients, visual acuity with correction ranged from 0.3 to 0.5. At different times after the operation, a relapse of retinal detachment occurred in two patients. In one patient with multiple degenerative changes in the periphery of the retina, a relapse of detachment was revealed 2 months after surgery. In all likelihood, the relapse was associated with the emergence of new ruptures in the dystrophy zone and the presence of a proliferative process. In another patient, a relapse of retinal detachment was also observed 4 months after surgery due to the progression of PVR (post-traumatic retinal detachment). All patients with a relapse of retinal detachment within 1–2 days after the detection of a relapse underwent a second operation with revision of the vitreous cavity and subsequent silicone tamponade, which led to complete adhesion of the retina. Conclusion. ROS surgery by subtotal vitrectomy with blocking of retinal tears with platelet-rich plasma and air tamponade is an effective one-stage technique that minimizes the traumatic effect of the operation, reduces postoperative inflammatory complications, and also reduces economic losses. Key words: rhegmatogenous retinal detachment, platelet-rich plasma. Key words: rhegmatogenous retinal detachment, platelet-rich plasma

scholarly journals Quality of life changes after surgical treatment of retinal detachment

2014 ◽  
Vol 7 (2) ◽  
pp. 23-29
Author(s):  
Z Zh Al-Rashid ◽  
Aleksey Vladislavovich Malyshev ◽  
Ol’ga Igorevna Lysenko
Keyword(s):  
Quality Of Life ◽  
Surgical Treatment ◽  
Retinal Detachment ◽  
Postoperative Period ◽  
Visual Function ◽  
Progressive Increase ◽  
Control Group ◽  
Life Changes ◽  
Late Postoperative Period

Purpose. To study the effect of vitrectomy in retinal detachment (RD) treatment on the quality of life (QOL) of patients. Methods. We examined 67 patients who underwent surgical treatment of RD. QOL was assessed by VFQ-25 questionnaire before surgery and after 1 week and 6 months of it. Results. When assessing QOL before surgery, there was a significant reduction of the total QOL index by an average of 35% in comparison to the control group (p < 0.001). In the late postoperative period, a progressive increase of the total QOL index and visual function was recorded. Conclusion. Vitrectomy for the treatment of retinal detachment improves patients’ visual function and quality of life.

scholarly journals Complications of various methods for implanting intraocular lenses in the surgical treatment of congenital cataract

2020 ◽  
pp. 53-56
Author(s):  
G. A. Fediashev ◽  
I. S. Kasatkina ◽  
E. S. Makarevich
Keyword(s):  
Visual Acuity ◽  
Surgical Treatment ◽  
Postoperative Period ◽  
Congenital Cataract ◽  
Vitreous Body ◽  
Development Rate ◽  
Intraocular Lenses ◽  
Epithelial Proliferation ◽  
Anterior Segments ◽  
Children Under 5

Objective: Comparison of complications development rate in various methods for implanting intraocular lenses (IOLs) in the surgical treatment of congenital cataract.Methods: The results of surgical treatment of 16 children under 5 years old with bilat‑ eral congenital cataract were assessed. In each case, IOL was implanted according to the technique “optic capture” into one eye (the 1st group of study); the lens was implanted after capsulorrhexis and extraction of anterior segments of vitreous body into the second eye (the 2nd group of study).Results: Fibrinoplastic complications in the postoperative period were more often recorded in the 2nd group than in the 1st one (5 and 1 eyes, respectively). Epithelial proliferation in the 2nd group developed in 10, in the 1st group – in 5 eyes.Conclusions: In the surgical treatment of congenital cataract, implantation of IOLs according to the technique “optic capture” is an effective way of epithelial proliferation and opacity prevention reducing visual acuity in postoperative period. This method is safe regarding inflammatory fibrinoplastic reactions and allows maintaining normal anatomical position of the vitreoretinal structures of the growing eye. 

scholarly journals Use of autologous conditioned platelet-rich plasma in the surgery of rhegmatogenous retinal ­detachment with large and multiple breaks, abruption from the dentate line

2019 ◽  
Vol 100 (4) ◽  
pp. 606-610
Author(s):  
D G Arsyutov
Keyword(s):  
Visual Acuity ◽  
Retinal Detachment ◽  
Postoperative Period ◽  
Rhegmatogenous Retinal Detachment ◽  
Platelet Rich Plasma ◽  
Vitreoretinal Surgery ◽  
Dentate Line ◽  
Early Postoperative Period ◽  
Multiple Breaks ◽  
Late Postoperative Period

Aim. To evaluate the effectiveness of surgical treatment of rhegmatogenous retinal detachment with large and multiple breaks, abruption from the dentate line with the use of 25, 27 Ga subtotal vitrectomy, pneumoretinopexy or silicone tamponade with blocking of retinal defects with the use of autologous conditioned platelet-rich plasma without endolaser coagulation around retinal defects. Methods. The surgery included 25, 27 Ga vitrectomy, posterior hyaline membrane removal, pneumoretinopexy, instillation of 2–3 layers of autologous conditioned platelet-rich plasma deprived of leukocytes and containing 1.5–2 times more platelets than in whole blood into the area of retinal detachment, its break or along the edge of retinotomy till the retinal defect is totally covered. A total of 27 patients with visual acuity 0.03 to 0.9 were treated. Results. In the early postoperative period 93% of patients had total retinal reattachment, in whim retinal detachment was blocked; 2 patients were reoperated. In the late postoperative period (1–12 months) 4 recurrent retinal detachments were registered, which also required reoperation. Visual acuity of the operated patients in the late postoperative period was 0.1–1.0. Conclusion. 25, 27 Ga vitreoretinal surgery of rhegmatogenous retinal detachment with large retinal breaks, abruption from the dentate line, including retinotomy and retinal defects blockage with the use of autologous conditioned platelet-rich plasma without the use of endolaser coagulation is a method which allows achieving total reattachment of retina, better function of the operated eye in most cases.

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.

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