Rapid Fire Saturday 19 May 08:00 - 09:32 Salle des Princes
B. Tatiana,
RUSSIA
Circular buckling surgery and enzyme therapy in treatment of traction retinal detachment in patients with diabetes mellitus
A circular buckling eye sheath surgery is known to render an effect of vitreoretinal relaxation. There are also data about preretinal blood re-distribution with the level decrease and its accelerated resorption. Purpose: To value a circular buckling surgery efficiency by a sponge graft in complex with an enzyme therapy in patients with diabetic traction retinal detachment. Methods: 26 patients were examined. A native silicone, sponge implant of 3 mm thickness and 5 mm in width was used for surgeries, and collalizin 1 KE, an enzyme preparation, was injected through pars plana, so far as it destroyed collagen’s molecules in the vitreoretinal bands and epiretinal membranes. An accented circlage was performed in 19 cases with an implant tension on 8 mm in the localization area of retinal detachment. A dynamic circlage was conducted in 7 patients with a tension on 10 mm. Collalizin N10 was injected parabulbarly after surgery in all patients. Results. A vitreous body secretion and fibrous proliferates from the retina, their noticeable thinning, a decrease of the height and traction detachment density were noted in 3 months. The repeated courses of the collalizin parabulbar injections were performed after this. A reversal fibrous tissue development, a traction detachment disappearance, a vascular stricture, a diffuse chorioretinal dystrophy were observed in 14 patients (73.6%) at the examination in 6 months. Visual acuity from 0.09 to 0.1 before the surgery increased to 0.1-0.3 in 6 patients. It remained unchanged in the rest of the cases. A visual function decrease from 0.1 to 0.03-0.05 and accompanying traction retinal detachment progression which occurred due to a partial hemophthalmia was noted in 5 out of 19 patients (26.3%) The visual acuity from 0.05-0.08 in the result of the fibrous proliferation regression and vitreoretinal traction relaxation increased to 0.09-0.1 in 6 months after surgery and 2 courses of parabulbar injections in 7 cases with the central traction retinal detachment. Conclusions: We observed positive results of this operation and enzyme therapy after 3-6-12 months.
