Preliminary results of surgical treatment of patients with rhegmatogenous retinal detachment with rupture in the lower departments
Authors:   Institute of Advanced Training of Physicians N.I. Pirogov National Medical Surgical Center, Moscow, Sekhina O.L. , Fayzrakhmanov R.R. ,   N.I. Pirogov National Medical Surgical Center, Moscow,   Institute of Advanced Training of Physicians N.I. Pirogov National Medical Surgical Center, Moscow, Konovalova K.I. ,   N.I. Pirogov National Medical Surgical Center, Moscow,   Institute of Advanced Training of Physicians N.I. Pirogov National Medical Surgical Center, Moscow, Larina E.A. ,   N.I. Pirogov National Medical Surgical Center, Moscow, Vaganova E.E. ,   Institute of Advanced Training of Physicians N.I. Pirogov National Medical Surgical Center, Moscow
Published: June 2024

Retinal regmatogenic detachment is a serious disease that causes complete irreversible blindness in the absence of operative treatment [1]. Despite the use of the latest technology, the risk of relapse of regmatogenic detachment with lower breaks in the conditions of tamponade of the real cavity with silicone oil is 10–25 % of cases, and after extrusion silicone oil — up to 34 % due to the preservation of the space between the retina surface and the lower meniscus of the silicone bubble, increasing the risk of progression of proliferative vitreoretinopathy [2, 3]. At present, in cases of pronounced proliferative vitreoretinopathy, where there is no intraoperative retinal attachment, a high risk of immediate retinal detachment, breaks in the lower quadrants, the tamponade of choice is the perfluorinated compound [4]. Purpose. To assess the effectiveness of short-term tamponade of the vitreal cavity by perfluorinated compound in patients with retinal regmatogenic detachment when localizing a tear in the lower retina. Material and methods. Analysis of treatment of 30 patients (30 eyes) with diagnosis of the primary regmatogenic retinal detachment with proliferative vitreoretinopathy C type 1–3 with macular zone capture has been performed, with the localization of rupture in the lower retina. All the patients were divided into two groups depending on the vitreal tamponade. I group (n = 14): vitreoretinal surgery was performed at the first stage with a 14 days twist tamponade of the perfluorinated compound cavity, and perfluorinated compound removal with subsequent tamponade of the gas-air mixture (C2F6) was performed at the second stage combined with facoemulsification and implantation of intraocular lens. II group (n = 16): the first step was vitreoretinal surgery with silicone oil tamponade 1300, the second step was silicone oil removal with a tamponade of the vitreal cavity with balanced saline solution. The observations were at least 6 months after perfluorinated compound or silicone oil removal. Results. According to our study, short-term perfluorinated compound tamponade was found to be more effective than silicone oil tamponade in patients with retinal detachment with lower lacerations, only 37.5 % of relapses were detected in group II. Conclusion: The effectiveness of the use of short-term tamponade of the vitreal cavity of perfluorinated compound in the treatment of patients with retinal detachment with lower retinal ruptures is confirmed by the results of the study. This method makes it possible to improve the anatomical and functional results of vitreoretinal surgery in this category of patients, reducing the risk of postoperative complications. Keywords: rhegmatogenous retinal detachment, tamponade of the vitreal cavity, perfluorinated compound