Russian Medical Inquiry
(RMZh. Meditsinskoe Obozrenie) ISSN 2587-6821 (Print), 2686-9918 (Online)

Prospects of two-port vitrectomy in the treatment of patients with epiretinal fibrosis

VAK

Scopus

E-libraryDimensions

russian citation indexULRICHS

roaddoaj

CyberleninkaGoogle Scholar

vinitiResearch4life

MendeleyScilit

РГБWhite list




Open accessCrossrefAntiplagiat

RMJ.ru




DOI: 10.32364/2311-7729-2022-22-4-224-227

D.V. Borisova1, I.A. Frolychev1,2, N.A. Pozdeeva1,2

1Cheboksary Branch of the S. Fyodorov Eye Microsurgery Federal State Institution, Cheboksary, Russian Federation

2Postgraduate Doctors Training Institute, Cheboksary, Russian Federation

Aim: to evaluate the efficacy and safety of two-port vitrectomy in the treatment of patients with epiretinal fibrosis.

Patients and Methods: surgical treatment using a two-port vitrectomy technique was performed in 25 patients (25 eyes) with epiretinal fibrosis. Patients with concomitant retinal pathology (e.g. diabetic or post-thrombotic retinopathy) and glaucoma were not included in the study. Of the total number of patients, 64% (n=16) were women and 36% (n=9) were men. The mean age of the patients was 61±6,4 years. The surgical procedure was based on the developed technology and conducted by the same surgeon in the same clinical setting. The surgical technique included the installation of two ports in the opposite quadrants: in the upper hemisphere for the vitreotome and instruments, and in the lower hemisphere — for the infusion cannula with a built-in endo-illuminator-chandelier as a single light source. Then, vitrectomy was performed according to the classical technique — the vitreous body was removed centrally, followed by membrane staining and membrane peeling, and partial tamponade with an air mixture. Patients were examined on day 1, one and three months after the surgical procedure. They underwent the basic ophthalmic examination, including visometry and tonometry. Op tical coherence tomography with retinal image analysis was used to assess the recovery of anatomical parameters.

Results: intra- or postoperative adverse events were not reported. All patients had stable anatomical results: the absence of horizontal tractions in the foveal zone and a retinal height reduction to 297±32 µm. The maximum functional effect — a decrease in metamorphopsia expression and an increase in best-corrected visual acuity by 0.48±0.1 vs. that at the baseline was observed 3 months after the surgery.

Conclusion: in addition to the classical three-port vitrectomy with xenon focal illuminator, it is possible to use the two-port vitrectomy with a mercury vapor chandelier illuminator. The advantage of this method is the reduction of surgical trauma.

Keywords: epiretinal fibrosis, two-port vitrectomy, phototoxicity, tyndallometry.

For citation: Borisova D.V., Frolychev I.A., Pozdeeva N.A. Prospects of two-port vitrectomy in the treatment of patients with epiretinal fibrosis. Russian Journal of Clinical Ophthalmology. 2022;22(4):224–227 (in Russ.). DOI: 10.32364/2311-7729-2022-22-4-224-227.


About the authors:

Darya V. Borisova — ophthalmologist of the Vitreoretinal Department, Cheboksary Branch of the S. Fyodorov Eye Microsurgery Federal State Institution; 10, av. Traktorostroiteley, Cheboksary, 428028, Russian Federation; ORCID iD 0000-0002-7335-5633.

Ivan A. Frolychev — C. Sc. (Med.), Head of the Research and Educational Department, Cheboksary Branch of the S. Fyodorov Eye Microsurgery Federal State Institution; 10, av. Traktorostroiteley, Cheboksary, 428028, Russian Federation; Associate professor of the Department of Ophthalmology, Postgraduate Doctors Training Institute of the Ministry of Public Health of Chuvashia; 27, Mikhail Sespel str., Cheboksary, 428018, Russian Federation; ORCID iD 0000-0002-2876-1755.

Nadezhda A. Pozdeeva — Dr. Sc. (Med.), Director of Cheboksary Branch of the S. Fyodorov Eye Microsurgery Federal State Institution; 10, av. Traktorostroiteley, Cheboksary, 428028, Russian Federation; Professor of the Department of Ophthalmology, Postgraduate Doctors Training Institute of the Ministry of Public Health of Chuvashia; 27, Mikhail Sespel str., Cheboksary, 428018, Russian Federation; ORCID iD 0000-0003-3637-3645.

Contact information: Darya V. Borisova, e-mail: darya.sychyova.94@mail.ru.

Financial Disclosure: no authors have a financial or property interest in any material or method mentioned.

There is no conflict of interests.

Received 05.09.2022.

Revised 19.09.2022.

Accepted 29.09.2022.

References
1. Machemer R., Buettner H., Norton E.W., Parel J.M. Vitrectomy: a pars plana approach. Trans Am Acad Ophthalmol Otolaryngol. 1971;75(4):813–820. PMID: 5566980.
2. Blodi C.F. David Kasner, MD, and the Road to Pars Plana Vitrectomy. Ophthalmol Eye Dis. 2016;8(Suppl 1):1–4. DOI: 10.4137/OED.S40424.
3. O’Malley C., Heintz R.M.Sr. Vitrectomy with an alternative instrument system. Ann Ophthalmol. 1975;7(4):585–588, 591–594. PMID: 1147502.
4. Fujii G.Y., De Juan E.Jr., Humayun M. et al. A new 25-gauge instrument system for transconjunctival sutureless vitrectomy surgery. Ophthalmology. 2002;109(10):1807–1812. DOI: 10.1016/s0161-6420(02)01179-x.
5. Oshima Y., Wakabayashi T., Sato T. et al. A 27-gauge instrument system for transconjunctival sutureless microincision vitrectomy surgery. Ophthalmology. 2010;117(1):93–102.e2. DOI: 10.1016/j.ophtha.2009.06.043.
6. Kochergin S.A., Ilyukhin O.E., Alipov D.G. The Role of Vitrectomy in Threatment of Epimacular Fibrosis. Ophthalmology in Russia. 2018;15(2):132–138 (in Russ.). DOI: 10.18008/1816-5095-2018-2-132-138.
7. Kachalina G.F., Doga A.V., Kasmynina T.A., Kuranova O.I. Epiretinal fibrosis: pathogenesis, outcomes, treatment methods. Fyodorov Journal of Ophthalmic Surgery. 2013;4:108–110 (in Russ.).
8. Li J., Liu S.M., Dong W.T. et al. Outcomes of transconjunctival sutureless 27-gauge vitrectomy for vitreoretinal diseases. Int J Ophthalmol. 2018;11(3):408–415. DOI: 10.18240/ijo.2018.03.10.
9. Mitsui K., Kogo J., Takeda H. et al. Comparative study of 27-gauge vs 25-gauge vitrectomy for epiretinal membrane. Eye (Lond). 2016;30(4):538–544. DOI: 10.1038/eye.2015.275.
10. Coppola M., Cicinelli M.V., Rabiolo A. et al. Importance of Light Filters in Modern Vitreoretinal Surgery: An Update of the Literature. Ophthalmic Res. 2017;58(4):189–193. DOI: 10.1159/000475760.
11. Charles S. Illumination and phototoxicity issues in vitreoretinal surgery. Retina. 2008;28(1):1–4. DOI: 10.1097/IAE.0b013e318156e015.
12. Capone A.Jr. Endoilluminator phototoxic maculopathy associated with combined ICG-assisted epiretinal membrane and internal limiting membrane peeling. Clin Ophthalmol. 2014;8:2501–2506. DOI: 10.2147/OPTH.S75592.
13. Pozdeyeva N.A., Frolychev I.A., Borisova D.V. A method of surgical treatment of diseases of the vitreomacular interface. RF patent for invention No. 2775807. Published 07.11.22. Bull. No. 20.
14. Nosov S.V. Treatment tactics of late post-vitrectomy vitreous hemorrhages in diabetic patients. Fyodorov Journal of Ophthalmic Surgery. 2011;3:53–56 (in Russ.).
15. Shkvorchenko D.O., Sharafetdinov I.Kh., Shakhabutdinova P.M. Two-port pars plana vitreomacular surgery without endoillumination. Vestnik oftal’mologii. 2019;135(5):80–84 (in Russ.). DOI: 10.17116/oftalma201913505180.
16. De Oliveira P.R., Berger A.R., Chow D.R. Vitreoretinal instruments: vitrectomy cutters, endoillumination and wide-angle viewing systems. Int J Retina Vitreous. 2016;2:28. DOI: 10.1186/s40942-016-0052-9.

License Creative Commons
This work is licensed under a Creative Commons «Attribution» 4.0 License.


Previous article
Next article