First Author: V.Kanyukov RUSSIA
Co Author(s): A. Kazennov A. Gorbunov I. Kazennova 0 0 0 0 0 0 0 0 0
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To represent case report of surgical treatment of traction retinal detachment in a month after sclera perforated injury by injection needle.
The S. Fyodorov Eye Microsurgery Federal State Institution Orenburg Branch
Patient 14 years old was admitted to Orenburg branch of The S.Fyodorov Eye Microsurgery Federal State Institution a month after the perforated scleral wound with a diagnosis : OD - a consequence of a perforated wound, traction retinal detachment ; OS - the operated retinal detachment (lack of vitreous); OU - pseudophakia, high degree myopia. Under inhalation anaesthesia, conjunctiva incision on the limb in the lower external segment and examination of sclera surface were made to identify the perforations in the sclera of the penetrating wound, which ones were not detected. Portacaths 25 Ga were fixed on the 2, 7 and 10 hours at 4 mm from the limbus. The traditional vitrectomy technique was used. Vitreous body was virtually absent, funnel retinal detachment was defined. Additionally, in the lower - internal department chandelier illumination was fixed for bimanual surgery technique. After removal of epiretinal contraction fibers circular retinotomy was made and subretinal membranes were removed. The retina was fully extended on perfluororganic compounds and laser photocoagulation of the retina was performed at the retinotomy margin. After 2 weeks, the patient (in relation to the general condition) sequential replacement of PFOS for silicone oil was made.
As a result of surgery there was achieved full adaption and adaptation of the retina. Visual function changed from the correct light projection to the field of view onset (limited to 10º) at the first postoperative day. At discharge, the visual acuity of the operated eye was 0.02. At the control examination in 1 month functional data remained unchanged. The patient was scheduled aspiration of silicone oil in 3 months.
Surgical treatment of traumatic traction retinal detachment in the remote period (more than 1 month) after primary surgical treatment of the wound or trauma itself can be quite effective. Modern technologies of vitreoretinal surgery allow getting good anatomical and functional results, excepting the cases of central retinal lesions, which retained only peripheral vision.