Prediction of late results of surgical treatment of traumatic retina detachment in eye injury of multiple origin
https://doi.org/10.21516/2072-0076-2023-16-3-39-46
Abstract
Purpose. To evaluate the possibility of predicting the anatomical and functional results of surgical treatment of traumatic retinal detachment (RD) in trauma of various geneses, taking into account the clinical picture and the severity of the proliferative syndrome based on large clinical data.
Materials and methods. A comprehensive analysis of the clinical picture (using 22 features) and long-term results of surgical treatment of 427 patients with traction traumatic RD (TRD) after open and closed eye injury was carried out. The patients were divided into 7 groups depending on the mechanism of injury. The observation period was 5 years.
Results. The most severe proliferative syndrome was observed in TRD after an open injury: OEI A (contusions with scleral rupture), OEI D (double puncture wound) and OEI E (explosive trauma with scleral rupture), when both the process of mooring and PVR are present, as well as with CEI A (contusion) in the event that after the first operation PVR continued to progress. We found a direct dependence of PVR activity in TRD on the area of the detached retina and the presence of a traumatic cataract, and the inverse dependence on the presence of intraocular foreign body (IFB), its size and the ability of IFB to cause metallosis. A direct dependence of long-term functional results of treatment on the PVR stage, the area of detached retina and the diagnosed retinal rupture during the first vitreoretinal surgical intervention was established.
Conclusion. In order to make the surgical treatment of TRD more effective, it is worth using antiproliferative drugs intravitreally during vitreoretinal surgery, especially in OEI A, OEI D and OGI E, when the proliferative syndrome is caused both by PVR and mooring, as well as in CEI A in the case of a pronounced PVR stage.
About the Author
N. L. Leparskaya
Helmholtz National Medical Research Center of Eye Diseases
Russian Federation
Russian Federation
Nataliya L. Leparskiya - Cand. of Med. Sci., leading researcher, department of ocular trauma and reconstructive surgery
14/19, Sadovaya-Chernogryazskaya St., Moscow, 105062
References
1. Neroev V.V. Visual impairment in the Russian Federation. All-Russian public organization Association of Ophthalmologists (In Russ.). Available at: http:// avo-portal.ru/events/reports/item/266-invalidnost-po-zreniyu-v-rossiyskoyfederatsii(accessed 03/07/2023).
2. Kuhn F, Pieramici DJ. Ocular Trauma. Principles and Practice. New York; Stuttgart; 2002.
3. Neroev V.V., Sarygina O.I. Reasons for the development of post-traumatic retinal detachment and a surgical method for its prevention. Oftal'mologicheskij zhurnal. 1995; 4: 220–2 (In Russ.).
4. Gundorova R.A., Neroev V.V., Kashnikov V.V. Eye injuries. Moscow: GEOTAR-Media; 2009 (In Russ.).
5. Volkov V.V., Boyko E.V., Shishkin M.M., et al. Closed eye injury (concept, prevalence). Epidemiology, etiopathogenesis, hospitalization, diagnosis, classification). Oftal'mokhirurgiya. 2005; 1: 13–7 (In Russ.).
6. Levkoeva E.F. Regeneration of a wound limited to the outer membranes / In: Levkoeva E.F. Wound process in the eye. Moscow; 1951: 79–98 (In Russ.) .
7. Khoroshilova-Maslova I.P., Babizhaev M.A., Ilatovskaja L.V., Kiseleva O.A., Gankovskaja L.V. Protocol for the prevention of proliferative vitreoretinopathy. Patent RF 2175223; 2001 (In Russ.).
8. Kornilova A.F., Makarova S.M., Sumarokova E.S., Borisov A.V. To the question about healing of perforating eye injuries. Oftal'mologicheskij zhurnal. 1981; 4: 204–5 (In Russ.).
9. Tahchidi H.P., Kazajkin V.N., Rapoport A.A. Tamponade of the vitreal cavity with silicone oil in retinal detachment surgery. Complications. Oftal'mohirurgija. 2004; 3: 4–7 (In Russ.).
10. Khoroshilova-Maslova I.P., Nabieva M.M., Leparskaya N.L. Morphogenesis of complications after longterm intraocular silicon oil filling (clinical histopathological study). Vestnik oftalmologii. 2012, 128 (4): 57–61 (In Russ.).
11. Sadaka A, Giuliari GP. Priloferative vitreoretinopathy current and emerging treatments. Clin Ophthalmol. 2012; 6: 1325–33. doi: 10.2147/OPTH.S2789
12. Mukai A, Koozauskas A, Mukai S, Kazlauskas A. A novel strategy to develop therapeutic approaches to prevent proliferative vitreoretinopathy. Am J. Pathol. 2011; 179 (6): 2931–40. doi: 10.1016/j.ajpath.2011.08.043
13. Kuhn F, Morris R, Witherspoon CD, et al. A standardized classification of ocular trauma. Ophthalmology. 1996; 103 (2): 240–3. doi: 10.1016/s0161-6420(96)30710-0
14. Pieramici DJ, Sternberg PJr, Aaberg TM Sr, et al. A system for classifying mechanical injuries of the eye (globe). The Ocular Trauma Classification Group. Am J Ophthalmol. 1997; 123 (6): 820–31. doi: 10.1016/s0002-9394(14)71132-8
15. Khoroshilova-Maslova I.P., Leparskaya N.L., Alpeeva E.V., Voroteliak E.A. Melfalan in the treatment of proliferative vitreoretinopathy (experimental study). Vestnik oftalmologii. 2020; 136 (4): 19–25 (In Russ.). doi: 10.17116/oftalma202013604119
16. Leparskaya N.L., Khoroshilova-Maslova I.P., Vodovozova E.L., et al. A method for the treatment of proliferative vitreoretinopathy using melphalan associated with liposomes in an experiment. Patent RF, № 2772520; 2022 (In Russ.). Avaible a t: https://www1.fips.ru/iiss/document.xhtml?faces-redirect=true&id=7be631867b6acc22ee4c584329108012 (accessed 01.08.2022).
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For citations:
Leparskaya N.L. Prediction of late results of surgical treatment of traumatic retina detachment in eye injury of multiple origin. Russian Ophthalmological Journal. 2023;16(3):39-46. (In Russ.) https://doi.org/10.21516/2072-0076-2023-16-3-39-46
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