First Author: V.Zaika RUSSIA
Co Author(s): A. Iakimov
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To present a clinical case of complete intrusion of a circular silicone buckle under the retina and to develop an algorithm for treating this complication.
S. Fyodorov Eye Microsurgery Federal State Institution, Irkutsk, Russia
Patient after surgery for retinal detachment 10 years ago. Visual acuity was 0.35. Ophthalmoscopy: a circular silicone buckle is seen intrusive under retina. Diagnosis: operated retinal detachment, intrusion of silicone buckle. To correct this complication, treatment algorithm has been developed: circular opening of conjunctiva and Tenon membrane, buckle removal, plasty of scleral defects with scleral material. When conjunctiva and Tenon membrane were opened, external fibrous-scleral canal of a circular silicone buckle was revealed. After removal of buckle, external filtration with decrease of eye tone was detected. To eliminate external filtration, plasty of fibrous-scleral canal was performed.
Examination on the first day after surgical treatment: visual acuity 0.02. The tone of the eye is normal. Anterior segment of the eye is without features. Ophthalmoscopy: hemorrhagic suspension in the vitreous cavity; the folds of the retina in the intrusion area are visualized; retina is attached in all segments. Examination on the third day after surgical treatment: visual acuity 0.05 sph (-5.0) 0.35. The tone of the eye is normal. Anterior segment is without features. Ophthalmoscopy: the vitreal cavity is clean; the folds of the retina in the area of intrusion; retina is attached in all segments.
1. All cases of severe complications of episcleral surgery of retinal detachment require an individual approach to treatment. 2. Intraoperative modification of the treatment algorithm allows not only minimizing traumatic effects on the eyeball, but also obtaining a good anatomical and functional result after surgical treatment of these complications.