Офтальмохирургия (Dec 2015)
THE METHOD OF REMOVING THE CORTICAL LAYERS OF THE VITREOUS DURING VITRECTOMY
Abstract
Purpose. To develop a new method of vitreous cortical layers removal during vitrectomy and to evaluate its effectiveness. Material methods. There were operated 18 eyes of 18 patients aged from 13 to 73 years. The study included patients with subtotal or total retinal detachment with the peripheral located breaks. The control group consists of 18 eyes of 17 patients with similar pathology, operated on using a standard aspiration – traction method for cortical vitreous layers. After anterior and middle layers vitrectomy by the standard technique, Kenalog was injected to visualize residual vitreous body then central parts of the retina were smoothened injecting perfluorocarbon liquid (PFCL) in an amount of 1-1.5 ml. After that, remote periphery of the vitreous was removed with application of a scleral compression. Cortical layers were separated, from the periphery to the center using alternation of aspiration and cutting modes reaching the PFCL level. Then, PFCL was completely aspirated, and the center of the cortical layers was removed. After removal of the cortical layers the PFCL reinjection tamponed the vitreous cavity. In order to maximize the complete evacuation of subretinal fluid a pinhole retinotomy at oraserrata was previously made. Results. There were no complications during surgical treatment. Intraoperatively the retina was attached in all cases. Silicone oil removal was performed 2-3 months postoperatively. The follow-up after silicone removal ranged from 3 to 12 months. In 2 patients there was a recurrent retinal detachment in long-term postoperative period. Conclusion. The application of this method in microinvasive vitreoretinal interventions allows to maximize the cortical vitreous layer removal and to reduce a probability of retinal detachment recurrence appearance.
