Офтальмохирургия (Apr 2017)

ASSESSMENT OF INDUCED INFLAMMATION IN PATIENTS AFTER RETINAL DETACHMENT ENDOVITREAL SURGERY

  • V. D. Zakharov,
  • P. V. Lyskin,
  • M. I. Zgoba

DOI
https://doi.org/10.25276/0235-4160-2017-1-72-77
Journal volume & issue
Vol. 0, no. 1
pp. 72 – 77

Abstract

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Purpose. To assess the degree of induced inflammation after endovitreal intervention (EVI) for retinal detachment based on a determination of C-reactive protein (CRP).Materials and methods. The study included an observational analysis of 140 patients. The test group I (n=46) consisted of patients who were treated for rhegmatogenous retinal detachment using endolaser photocoagulation (ELP). The patients of this group were divided into three subgroups depending on the volume of the performed ELP. The control group II (n=46) included patients with the operated macular hole and with the status after silicone oil endo-tamponade. In this group we removed silicone oil. Patients with pathologies in macular area after previous vitrectomy comprised the control group III (n=48). In the control groups the ELP was not carried out. The CRP level in blood serum was evaluated pre and post-operatively using the Humatex CRP “HUMAN” device. Inflammation manifestations before and after surgery in early and late postoperative periods were assessed according to clinical signs of inflammatory reaction.Results. Aseptic exudative reaction in the anterior chamber in early postoperative periods and the highest frequency of epi-retinal fibrosis in long-term follow-up were detected in patients of the test group operated on for rhegmatogenous retinal detachment. There was obvious positive connection between intraoperative injuries caused by ELP, and the CRP level increase, and the intensity of inflammatory response.Conclusion. The CRP level indicates an inflammatory process caused by ELP. The increased CRP level shows a subclinical inflammatory process and is associated with an increased risk of pathological membranes formation. Presence of silicone oil in vitreous cavity does not induce an inflammatory response or statistically significant changes in the CRP level. Excessive intraoperative retinal burns may be one of the risk factors of postoperative inflammatory reaction development. It seems reasonable to reduce a volume of ELP to the minimum necessary level.

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