Vestnik oftalmologii · 2020
[Indications for retinal laser coagulation in the treatment of retinoschisis and rhegmatogenous retinal detachment].
СтатьяНазвание и аннотация: Оригинал на русском
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Velieva I A, Surnina Z V
Аннотация
PURPOSE: To determine the indications and assess the effectiveness of laser coagulation of the retina (RLC) after different types of surgeries for retinal detachment (RD), except vitrectomy.
MATERIAL AND METHODS: The study included 160 patients (165 eyes) with various types of retinal detachment and retinoschisis who remained under observation for 11 years.
RESULTS: In case of retinal tear with a slight local RD (less than one quadrant), we recommend the use of RLC as monotherapy. Such patients are indicated to undergo regular examinations (1 month, 3 months, 6 months, 1 year). Due to risk of tractional defects of the retina in the lower quadrants during the introduction of gas-air mixture into the vitreous cavity, in the presence of retinal pathology it is recommended to perform RLC before the pneumatic retinopexy stage. In large retinal tears, despite their upper localization, pneumatic retinopexy is not indicated due to the possibility of gas spilling over the edges of the tear under the retina, leading to an increase in the initial size of the tear and spread of RD. We noted the effectiveness of RLC monotherapy for retinal detachment of various localization. After sealing the sclera, retinal laser coagulation on the shaft along the seal is necessary to limit the tear along the edge, since over time the seal may shift causing a relapse of RD.
CONCLUSION: The study has confirmed the effectiveness of laser coagulation of the retina as an independent method for the treatment of retinoschisis and retinal tears with local detachment.
MATERIAL AND METHODS: The study included 160 patients (165 eyes) with various types of retinal detachment and retinoschisis who remained under observation for 11 years.
RESULTS: In case of retinal tear with a slight local RD (less than one quadrant), we recommend the use of RLC as monotherapy. Such patients are indicated to undergo regular examinations (1 month, 3 months, 6 months, 1 year). Due to risk of tractional defects of the retina in the lower quadrants during the introduction of gas-air mixture into the vitreous cavity, in the presence of retinal pathology it is recommended to perform RLC before the pneumatic retinopexy stage. In large retinal tears, despite their upper localization, pneumatic retinopexy is not indicated due to the possibility of gas spilling over the edges of the tear under the retina, leading to an increase in the initial size of the tear and spread of RD. We noted the effectiveness of RLC monotherapy for retinal detachment of various localization. After sealing the sclera, retinal laser coagulation on the shaft along the seal is necessary to limit the tear along the edge, since over time the seal may shift causing a relapse of RD.
CONCLUSION: The study has confirmed the effectiveness of laser coagulation of the retina as an independent method for the treatment of retinoschisis and retinal tears with local detachment.