[Preventive laser treatment of tractional symptomatic retinal flap tears: long-term outcomes].

Autor:	Shaimova VA; Multidisciplinary center of laser medicine, Chelyabinsk, Russia.; LLP «CENTER» VISION», Chelyabinsk, Russia., Shaimov TB; LLP «CENTER» VISION», Chelyabinsk, Russia., Boiko EV; LLP «CENTER» VISION», Chelyabinsk, Russia., Shaimov RB; Saint Petersburg branch of S.N. Fyodorov National Medical Research Center «MNTK «Eye Microsurgery», Saint Petersburg, Russia.; I.I. Mechnikov North-Western State Medical University, Saint Petersburg, Russia.; S.M. Kirov Military Medical Academy, Saint Petersburg, Russia., Zarezina AS; Chelyabinsk State University, Chelyabinsk, Russia., Kravchenko TG; Multidisciplinary center of laser medicine, Chelyabinsk, Russia., Galin AY; LLP «CENTER» VISION», Chelyabinsk, Russia., Kuchkildina SK; LLP «CENTER» VISION», Chelyabinsk, Russia., Shaimova TA; LLP «CENTER» VISION», Chelyabinsk, Russia., Aksenfeld GV; Chelyabinsk Regional Clinical Hospital of No. 3, Chelyabinsk, Russia., Fomin AV; Tradomed Invest comp., Moscow, Russia.
Jazyk:	ruština
Zdroj:	Vestnik oftalmologii [Vestn Oftalmol] 2020; Vol. 136 (3), pp. 32-38.
DOI:	10.17116/oftalma202013603132
Abstrakt:	Tractional flap tears are the main cause of the development of regmatogenic retinal detachment (RRD). The main immediate treatment method for it is laser retinal coagulation. Purpose: Case monitoring of tractional symptomatic flap tears after laser treatment. Material and Methods: From 2014 to 2019 we observed 119 patients (130 eyes) with peripheral flap (horseshoe) retinal tears in acute posterior vitreous detachment. Laser coagulation of the retina was performed using Navilas 577s (577 nm), OcuLight GL (532 nm). Laser retinotomy of horseshoe tear flap and dissection of overhanging vessels were performed using Nd:YAG-ultra Q Reflex laser (1064 nm) and controlled with RTVue XR Avanti. Results: At the initial examination before the preventive laser coagulation, the following conditions were found: regmatogenous retinal detachment (RRD) - 8 eyes (6.2%), partial hemophthalmus - 29 (22.3%), preretinal hemorrhage - 15 (11.5%), epiretinal membrane - 9 (6.9%), non-full-thickness macular retinal breaks - 6 (4.6%), peripheral changes: retinal holes - 16 (12.3%), tears with operculum - 5 (3.8%), retinal degenerations - 40 eyes (30.8%). Observation for 5 years after laser retinopexy revealed new pathological changes: flap tears - 13 (10.6%); holes - 9 (7.4%); tears with operculum - 5 (4.1%); vitreoretinal tuft - 6 (4.9%); RRD - 3 cases (2.5%). In 16 patients (16 eyes) with horseshoe tear and pronounced vitreoretinal traction, the flap retinotomy was performed, which eliminated the traction component and prevented the development of RRD. Conclusion: Follow-up of tractional symptomatic flap tears for 5 years after preventive laser retinopexy revealed the appearance of retinal detachment in 2.5% of cases. Laser retinotomy of horseshoe tear after barrier retinopexy eliminated the traction component and helped prevent the development of RRD.
Databáze:	MEDLINE
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