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 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.

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 Outcome of Scleral Buckling Surgery in Rhegmatogenous Retinal Detachment

1970 ◽  
Vol 6 (1) ◽  
pp. 21-24
Author(s):  
MI Hossain ◽  
MK Hasan ◽  
MSM Ali
Keyword(s):  
Visual Acuity ◽  
Retinal Detachment ◽  
Rhegmatogenous Retinal Detachment ◽  
Armed Forces ◽  
Scleral Buckling ◽  
Scleral Buckle ◽  
Medical College ◽  
Open Globe ◽  
Retinal Reattachment ◽  
History Of

A longitudinal study was carried out in the vitreo-retina clinic of the National Institute of Ophthalmology andHospital (NIO&H) on 30 eyes of 25 patients who were treated with scleral buckle (SB) surgery during theperiod of October 2004 to September 2005 of either sex. The aim of this study was to determine the outcome ofSB surgery in Rhegmatogenous retinal detachment (RRD). The main entry criteria for this study wereprimary RRD treated with SB and for which 12 weeks of follow-up were available. The eyes with proliferativevitreoretinopathy or with history of SB surgery, vitrectomy, posterior segment open-globe trauma orsignificant concurrent eye disease e.g. amblyopia, macular disease etc were excluded from this study. Overalltwenty-four eyes (80%) achieved retinal reattachment with one SB procedure (encircling or segmental); themedian 12-week visual acuity was 6/12. Three additional eyes (10%) achieved retinal reattachment with onevitreoretinal procedure; the median 12-week visual acuity was 6/9. Three eyes (10%) never achieved retinalreattachment despite one additional vitreoretinal procedure, and 12-week visual acuity was no perception oflight. It can be concluded that SB for primary RRD achieves anatomical efficacy and preservation of centralvision in the majority of eyes.Key words: Scleral buckle; Rhegmatogenous retinal detachment outcome.DOI: 10.3329/jafmc.v6i1.5987Journal of Armed Forces Medical College, Bangladesh Vol.6(1) 2010 p.21-24

scholarly journals Parsplana vitrectomy alone versus parsplana vitrectomy combined with phacoemulsification for the treatment of rhegmatogenous retinal detachment: a randomized study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Paolo Mora ◽  
Stefania Favilla ◽  
Giacomo Calzetti ◽  
Giulia Berselli ◽  
Lucia Benatti ◽  
...  
Keyword(s):  
Retinal Detachment ◽  
Rhegmatogenous Retinal Detachment ◽  
Randomized Study ◽  
Retinal Breaks ◽  
Retinal Tears ◽  
Retinal Reattachment ◽  
Group A ◽  
The Difference ◽  
Group B

Abstract Background To compare parsplana vitrectomy (PPV) with and without phacoemulsification to treat rhegmatogenous retinal detachment (RRD). Methods Subjects aged 48–65 years with RRD in a phakic eye due to superior retinal tears with an overall extension of retinal breaks < 90° underwent to PPV alone (group A); or PPV plus phacoemulsification (phacovitrectomy, PCV, group B). Post-operative follow-up visits occurred at 1 week, 1 month (m1), 3 months (m3), and 6 months (m6) after surgery. The main outcome was the rate of retinal reattachment. Secondary outcomes included best-corrected visual acuity (BCVA), intraocular pressure (IOP), central macular thickness (CMT), and cataract progression (in the lens-sparing [PPV-alone] group). Results In this initial phase of the study a total of 59 patients (mean age: 55 years, 59 eyes) were enrolled: 29 eyes in group A and 30 eyes in group B. Both groups had similar gas tamponade. During the follow-up there were three cases of RRD recurrence in group A and one in group B. The relative risk of recurrence in group A was 3.22 times higher but the difference was not significant (p = 0.3). The two groups were also similar in terms of BCVA and IOP variation. At m3, CMT was significantly higher in group B (p = 0.014). In group A, cataract progression was significant at m6 (p = 0.003). Conclusions In a cohort of RRD patients selected according to their preoperative clinical characteristics, PPV was comparable to PCV in terms of the rate of retinal reattachment after 6 months. Trial registration ISRCTN15940019. Date registered: 15/01/2021 (retrospectively registered).

Foveal bulge as a predictor of high visual function in rhegmatogenous retinal detachment

2021 ◽  
pp. 234-238
Author(s):  
R.R. Fayzrakhmanov ◽  
◽  
A.V. Sukhanova ◽  
Keyword(s):  
Visual Acuity ◽  
Retinal Detachment ◽  
Outer Segment ◽  
Rhegmatogenous Retinal Detachment ◽  
Silicone Oil ◽  
Outer Nuclear Layer ◽  
Control Group ◽  
Ophthalmological Examination ◽  
Outer Segments ◽  
Group 2

Introduction. The integrity of photoreceptor's inner segment/outer segment connection plays great importance in predicting visual acuity in eyes with retinal pathology. However, even optical coherence tomographic study showed the intact of retinal layers, including photoreceptor's inner segment/outer segment line, after surgery due to rhegmatogenous retinal detachment (RRD), low visual acuity is observed. Purpose. to identify predictors of high visual acuity in the foveolar zone in patients after successful RRD repair according to SD-OCT. Material and methods. Group 1 consisted of 20 cases – eyes after successful primary RRD repair performed through pars plana vitrectomy using silicone oil tamponade (1300 cSt), followed by removal of silicone oil with a replacement for sterile air. Group 2 – control, followed eyes without ophthalmopathology and visualisation of foveolar bulge according to OCT. All patients underwent a standard ophthalmological examination and OCT on the 30th day after silicone oil removal. OCT examination was performed by Retina Map and Cross Line modes. The lengths of the outer segments of photoreceptors, inner segments of photoreceptors and the outer nuclear layer of the layer were measured in manual mode. Retina Map was used to measure retinal foveolar thickness. Results. During the study, the data of the foveolar thickness of the retina, the outer nuclear layer and the length of the outer segment of photoreceptors in the main group showed a significant decrease in comparison with the control group (p=0.002, p=0.006, p=0.02, respectively). In this case, a strong correlation was obtained only between the length of the outer segments of photoreceptors and visual acuity (r=0.68). Conclusion. The length of the outer segments of the cones in the central retinal area, or foveolar bulge, should considers a predictor of high visual acuity twostage surgical treatment of primary RRD using silicone oil. Key words: retinal detachment, foveolar bulge, ellipsoid zone, vitrectomy, OCT.

scholarly journals Parsplana Vitrectomy Alone Versus Parsplana Vitrectomy Combined With Phacoemulsification for The Treatment of Rhegmatogenous Retinal Detachment: A Randomized Study

2021 ◽  
Author(s):  
Paolo Mora ◽  
Stefania Favilla ◽  
Giacomo Calzetti ◽  
Giulia Berselli ◽  
Lucia Benatti ◽  
...  
Keyword(s):  
Retinal Detachment ◽  
Rhegmatogenous Retinal Detachment ◽  
Randomized Study ◽  
Retinal Breaks ◽  
Retinal Tears ◽  
Retinal Reattachment ◽  
Group A ◽  
The Difference ◽  
Group B

Abstract BACKGROUND: To compare parsplana vitrectomy (PPV) with and without phacoemulsification to treat rhegmatogenous retinal detachment (RRD).DESIGN: parallel, randomized trial.METHODS: subjects aged 48 - 65 years with RRD in a phakic eye due to superior retinal tears with an overall extension of retinal breaks < 90° underwent to PPV alone (group A); or PPV plus phacoemulsification (phacovitrectomy, PCV, group B). Post-operative follow-up visits occurred at 1 week, 1 month (m1), 3 months (m3), and 6 months (m6) after surgery. The main outcome was the rate of retinal reattachment. Secondary outcomes included best-corrected visual acuity (BCVA), intraocular pressure (IOP), central macular thickness (CMT), and cataract progression (in the lens-sparing [PPV-alone] group).RESULTS: in this initial phase of the study a total of 59 patients (mean age: 55 years, 59 eyes) were enrolled: 29 eyes in group A and 30 eyes in group B. Both groups had similar gas tamponade. During the follow-up there were three cases of RRD recurrence in group A and one in group B. The relative risk of recurrence in group A was 3.22 times higher but the difference was not significant (p = 0.3). The two groups were also similar in terms of BCVA and IOP variation. At m3, CMT was significantly higher in group B (p = 0.014). In group A, cataract progression was significant at m6 (p = 0.003).CONCLUSIONS: In a cohort of RRD patients selected according to their preoperative clinical characteristics, PPV was comparable to PCV in terms of the rate of retinal reattachment after 6 months.TRIAL REGISTRATION: ISRCTN15940019Date registered: 15/01/2021 (retrospectively registered)

scholarly journals Laser treatment of macular retinal folds in late postoperative period after retinal detachment repair

2021 ◽  
Author(s):  
KhP Takhchidi ◽  
EKh Takhchidi ◽  
TA Kasmynina ◽  
EP Tebina
Keyword(s):  
Retinal Detachment ◽  
Postoperative Period ◽  
Rhegmatogenous Retinal Detachment ◽  
Clinical Symptoms ◽  
Vascular Occlusion ◽  
Early Postoperative Period ◽  
Repeat Surgery ◽  
Retinal Vascular Occlusion ◽  
Retinal Folds ◽  
Late Postoperative Period

Macular retinal folds are a rare yet grave complication of surgical rhegmatogenous retinal detachment repair. Clinical symptoms vary depending on the location and severity of folding. Fold located in the periphery of the ocular fundus can be asymptomatic, but macular retinal folds cause diminished visual acuity and metamorphopsia. Currently, the most effective treatment for retinal folds is repeat surgery. Its serious disadvantage is the risk of complications in the early postoperative period, including hemophthalmia, inflammation, secondary glaucoma, cataracts, RRD recurrence, macular tears, retinal vascular occlusion, etc. The clinical case described below demonstrates the potential of combination laser therapy for the treatment of macular retinal folds based on the use of modern diagnostic and therapeutic methods.

scholarly journals Surgery of cicatricial stage of choroidal neovascular membrane with autologous conditioned plasma

2021 ◽  
Vol 14 (4) ◽  
pp. 18-21
Author(s):  
D. G. Arsyutov
Keyword(s):  
Visual Acuity ◽  
Silicone Oil ◽  
Platelet Rich Plasma ◽  
Functional Results ◽  
Suture Fixation ◽  
Choroidal Neovascular Membrane ◽  
Inner Limiting Membrane ◽  
Silicone Oil Tamponade ◽  
Late Postoperative Period

Purpose. To estimate the effectiveness of the cicatricial stage of choroidal neovascular membrane (CNM) surgery with retina fixation after retinotomy of paracentral areas with autologous conditioned platelet rich plasma (ACP) and without endolaser photocoagulation and silicone oil tamponade. Material and methods. 17 CNM patients aged 49 to 82 with visual acuity from 0.02 eccentric to 0.08 were operated. The operation consisted in 25-, 27+-gauge vitrectomy, removal of the posterior hyaloid membrane and the inner limiting membrane (in the presence of an epiretinal membrane), paracentral retinotomy, removal of the choroidal neovascular membrane via retinotomy, pneumoretinopexy, 2–3 layer instillation of ACP in the retinotomy area without endolaser photocoagulation and silicone oil tamponade, seamless closure of sclera- and conjunctivotomy with a layer of autologous conditioned plasma. Results. Full retinal reattachment and closure of the retinotomy opening in the late postoperative period was noted in all patients. No case of recurrent retinal detachment was recorded. Complete closure of sclera- and conjunctivotomy with no additional suture fixation was achieved in all cases. In the long-term period after the removal of the cicatricial choroidal membrane, visual acuity was 0.03–0.2. Conclusion. The modern surgery of the cicatricial stage of CNM using ACP to close the retinotomy defect after removal of cicatricial CNV without endolaser coagulation of the retina and silicone tamponade, followed by seamless blocking of the sclero- and conjunctivotomy with ACP produces excellent anatomical and functional results, minimizing the risk of postoperative complications.

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