Surgical treatment of damage to the posterior capsule of the lens after laser vitreolysis

Author(s):  
А.А. Kozhukhov ◽  
◽  
О.V. Unguryanov ◽  
О.А. Chukanin ◽  
◽  
...  

Damage to the posterior capsule of the lens after laser vitreolysis causes the formation of traumatic cataracts and a decrease in visual acuity. The search for surgical methods of treating such complications is relevant. Purpose. To develop and improve the technique of posterior capsulorexis during phacoemulsification and implantation of IOL combined with vitrectomy in the presence of an initial injury of the posterior lens capsule. Material and methods. Clinical case - a patient came to the clinic with complaints about a decrease in visual acuity and quality after laser vitreolysis performed in another clinic. Observed the damage of the posterior capsule of the lens. The operation was performed according to the developed technique. Results. A method of primary posterior capsulorexis during phacoemulsification and implantation of IOL after vitreolysis, combined with vitrectomy, is proposed. Achieved high visual acuity after the operation, OD=1.0. Conclusions. 1) The developed technique of primary posterior capsulorexis is safe and allows partially preserving the posterior capsule of the lens, while forming a «window» in the area of damage, and implanting the IOL into a capsule bag. 2) The installation of scleral ports during primary posterior capsulorexis makes it possible to successfully combine this operation with vitrectomy and prevent the displacement of lens fragments to the fundus. Key words: сataract, posterior capsulorexis, laser vitreolysis, phacoemulsification, pseudophakia, IOL, vitrectomy, vitreous body.

Author(s):  
S.I. Makogon ◽  
◽  
E.N. Kuznetsova ◽  
Y.A. Bryukhanova ◽  
◽  
...  

Purpose. To present the course of a complete macular rupture, depending on the management tactics. Material and methods. On the example of two clinical cases, the outcome of a complete macular rupture is presented: without surgical treatment and as a result of surgery. Results. Surgical methods of treatment made it possible to obtain high visual functions in the patient - visual acuity up to 0.9. Conclusions. Modern methods of surgical treatment of MR provide restoration of the structure of the outer layers of the retina and high visual functions, provided that the optical media of the eye are transparent. Key words: macular rupture, surgical treatment of macular rupture, course of macular rupture without treatment.


Author(s):  
S.V. Milova ◽  
◽  
A. Daxer ◽  

Keratoconus is a progressive degenerative disease in which, due to the weakening of the biomechanical strength of the cornea, its cone-shaped deformation occurs, leading to the development of induced myopia and astigmatism, as well as to a decrease in corrected visual acuity. Treatment of this disease consists in achieving stabilization of the process by strengthening the structure of the cornea, as well as in correcting refractive disorders caused by corneal deformation. Purpose. The purpose is to evaluate the effectiveness of correction of refractive disorders by implanting a closed MyoRing ring in the corneal stroma of patients with keratoconus. Material and methods. The data of 98 MyoRing implantation operations using CISIS technology using the PoketMaker ultraceratom for stage 3-4 keratoconus were analyzed. The observation period is up to 9 years. The initial myopia averaged -9.23 D ±3.82, astigmatism-6.13 ±2.51. Results. Stabilization of the refractive effect occurred usually within 3-6 months after surgery. On average, the following correction of refractive disorders was achieved: myopia-8.14 D ± 2.67 and astigmatism-4.28 D ± 2.12. Keratometry indicators also in most cases stabilized within 3-6 months after surgery and remained unchanged throughout the entire follow-up period. Conclusions. Implantation of a closed MyoRing ring in keratoconus makes it possible to significantly correct refractive disorders and prevents further progression of the disease. Key words: keratoconus, MyoRing, SISI, ring implantation in keratoconus.


Author(s):  
D.R. Mamulat ◽  
◽  
I.L. Plisov ◽  
N.G. Antsiferova ◽  
M.A. Sharokhin ◽  
...  

Purpose. To evalute the effective of the proposed volume of surgical treatment for the progressive course of infant esotropia. Material and мethods. A premature baby with congenital esotropia, which was diagnosed at the sith month of life. The patient was assigned a spectacle correction taking into account the par of ametropia and constant alternating occlusion. In connection with the subsequent increase in horizontal esodeviation and the appearance of a paretic component, a bilateral recession of the internal rectus muscle by 5mm was carried out in combination with an injection of Botox in a volume of 2.0. IU. Results and discussion. After the first stage of surgical treatment, a stable decrease of horizontal esodeviation and an increase of the amount of abduction were achieved. Conclusion. Bilateral combined weakening of medial rectus muscles (classical recession and chemorecession) allows to achieve predicted good results in case of large strabismus angles, combined with limi of abduction. Key words: congenital esotropia, chemodenervation, chemorecession.


2018 ◽  
Vol 11 (1) ◽  
pp. 78-84 ◽  
Author(s):  
Sergey Yu Astakhov ◽  
Inna A Riks ◽  
Sanasar S Papanyan ◽  
Sergey A Novikov ◽  
Georgiy Z Dzhaliashvili

Primary endothelial dystrophy of the cornea is a fairly common disease in people older than 50 years. Well-developed methods of conservative treatment, as a rule, do not lead to improvement or stabilization of the functional state of the cornea. The choice of tactics of surgical treatment from the existing variety of techniques is complicated. There are isolated reports of the restoration of corneal transparency after descemet membrane removal. The author's method of endothelial corneal dystrophy treatment addressed in this particular clinical case - a combination of isolated descemetorhexis and collagen cross-linking - resulted in impressive increase in visual acuity and significant improvement in objective criteria for the morpho-functional state of the cornea. (For citation: Astakhov SYu, Riks IA, Papayan SS, et al. About a new approach to surgical treatment of corneal endothelial dystrophy. Ophthalmology Journal. 2018;11(1):78-84. doi: 10.17816/OV11178-84).


2010 ◽  
Vol 16 (2) ◽  
pp. 51-54
Author(s):  
A. K. Dulaev ◽  
V. D. Usikov ◽  
D. A. Ptashnikov ◽  
E. M. Fadeev ◽  
A. V. Dydykin ◽  
...  

The article is dedicated to the vital problem of the consequences caused by negligent surgical treatment of those who suffered spinal and vertebral trauma. The authors carried out a cooperative survey of the results of the previous treatments of patients with traumas with and without complications and they came up with the algorythm of surgical methods, based on the data analysis. Vast database of 614 clinical case treatments with post-operative observations of 1 to 10 years long have been used. The work is aimed at raising the standarts of surgical treatments and improvement of neurological anatomo-functional results.


2019 ◽  
Vol 12 (1) ◽  
pp. 37-44
Author(s):  
Konstantin S. Zhogolev ◽  
Yaroslav V. Bayborodov

In this review, the opinions of different authors on the problem of non-full thickness macular holes are discussed in detail. Currently, there are three different approaches to the management of this condition. Dynamic observation allows assessing the degree of their progression, to determine some or other anatomical indicators which influence the functional state of the retina and visual function. Pharmacological vitreolysis in some cases allows eliminating vertical and tangential traction in a least invasive mannor. To resolve this problem in a radical way is possible by surgical treatment posterior vitrectomy, but this is also related to certain surgical risks, and does not always lead to an increase in visual acuity. As a rule, it is recommended to patients with a significant decrease in visual acuity. Currently, indications for surgical treatment of patients with high visual function are ambiguous.


Author(s):  
S.V. Ivanov ◽  
◽  
V.S. Samartsev ◽  
P.F. Ivanova ◽  
◽  
...  

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


2020 ◽  
pp. 53-56
Author(s):  
G. A. Fediashev ◽  
I. S. Kasatkina ◽  
E. S. Makarevich

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. 


Author(s):  
V.S. Stebnev ◽  
◽  
S.D. Stebnev ◽  
N.I. Skladchikova ◽  
T.Y. Vashchenko ◽  
...  

A clinical case of unintentional implantation of the Ozurdex dexamethasone implant (Allergan, Inc., Irvine, CA, USA) into the lens is presented. The patient was treated for a long time with intravitreal injections of Lucentis (5) and Ozurdex (4) in various clinics of the Russian Federation for recurrent macular edema associated with thrombosis of the n/temporal branch of the central retinal vein. After the last injection of Ozurdex, he noted a decrease in visual acuity. I applied to the Eye Surgery clinic after 5 months due to a significant decrease in visual acuity. After the examination, a cataract was diagnosed, an implant in the thickness of the lens. Phacoemulsification was successfully performed with the implantation of an intraocular lens into a capsule bag (UltraSert, Alcon). An attempt during the operation to preserve the Ozurdex implant and move it into the retrolental space failed, which was due to the long period of its stay in the eye and rapid hydrotation and destruction under the action of irrigation solution. High visual acuity was obtained. The optical coherence tomogram revealed complete relief of macular edema. Key words: Ozurdex®, intralenticular implantation Ozurdex®, complications of intravitreal injections, macular edema, iatrogenic cataract.


Author(s):  
V.A. Rudenko ◽  

Purpose. To evaluate the result of surgical treatment of submacular hemorrhage in patient with exudative age-related macular degeneration (AMD) by subretinal injection Gemase® and pneumatic retinopexy of blood clot. Material and methods. The article presents a clinical case of surgical treatment of submacular hemorrhage in patient with exudative AMD. The patient underwent three-port 25G vitrectomy, subretinal injection Gemase® 2000 ME by 38G needle, after which pneumatic retinopexy was performed. Results. Next day after the operation, there was displacement of subretinal blood clot from macula beyond out the lower vascular arcade. When observed after 6 months, the subretinal hemorrhage completely resolved, there was a regression of activity of subretinal neovascular membrane and macular edema, the retina was adherent in all cases. Visual acuity has improved. There was no recurrence of hemorrhage. Conclusion. This method of treatment allows you to increase and maintain the central visual acuity, as well as significantly reduce size of absolute central scotoma. Key words: submacular hemorrhage, recombinant prourokinase, Gemase®, exudative age-related macular degeneration, choroidal neovascularization, subretinal neovascular membrane.


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