Functional results of surgical treatment of retinal detachment
Journal: RUDN Journal of Medicine (Vol.24, No. 2)Publication Date: 2020-05-27
Authors : O. Ilyukhin; M. Frolov; K. Ignatenko;
Page : 156-162
Keywords : retinal detachment; visual acuity; scleral buckling; vitrectomy; blood flow; optical coherence tomography; photoreceptors;
Abstract
The article analyzes the state of patients’ visual acuity after successful surgical treatment of retinal detachment. On the basis of gathered data, it was concluded that in case of detachment of the macula only in 50% of cases it is possible to increase visual acuity to 0.4 and higher. Restoration of visual functions continues for at least 6 months after the operation and is determined by the restoration of the structure of the outer segments of the photoreceptor cells. During this time, it is advisable to conduct drug therapy aimed at normalizing blood flow and functional activity of the retina. Visual functions recovery continues for at least 6 months after the operation and is connected with the restored structure of the outer segments of the photoreceptor cells. Important prognostic factors of central vision restoration in the postoperative period are visual acuity before surgery, duration of existence and height of macular detachment. Data on which of the methods of surgical treatment of retinal detachment allows to achieve higher visual acuity are contradictory. There is practically no data on the comparison of the effect on visual acuity of scleral buckling and vitrectomy in the long-term period, in patients with phakic eyes and with artiphakia. On visual acuity after fitting detachment of the macula may affect macular edema, epiretinal membrane formation and retinal folds, and edema of the peripapillary optic nerve head, progressive deterioration of blood flow in the basin of the central retinal artery, short posterior ciliary arteries and ophthalmic artery. It is believed that these factors are significantly more pronounced after scleral buckling than after vitrectomy. Some indicators of optical coherence tomography correlate with visual acuity after surgical treatment of retinal detachment: the state of the articulation line of the external and internal segments of the photoreceptors, as well as the state of the external limiting membrane.
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