Imshenetskaya T., Birich T., Savitch A.

Department of Ophthalmology, Belorussian State Medical University, Republican Center for Reconstructive Eye Microsurgery (The Third Clinical Hospital), Republic Belarus

Purpose: To evaluate the efficiency and safety of the combined using encircling band and laser photocoagulation in the treatment of the proliferative diabetic retinopathy.
Methods: We followed 84 patients (167 eyes) with diabetes mellitus from 1996 till 1998. 28 patients (56 eyes) had NIDDM, 56 patients (111 eyes) had IDDM. B - scan allowed us to diagnose traction retinal detachment in 57 patients; severe proliferative vitreous tractions with local retinal detachment in 27 patients.
Results and Conclusion: We performed encircling procedure with silicone sponge in 154 eyes; pars plana vitrectomy in 76 eyes. Due to encircling band 78 patients had PDR stabilized without vitrectomy. In our study we tried to increase the firmness of the chorioretinal adhesion achieved by encircling procedure using postoperative laser session at the 1 - 2 months intervals. Improvement of visual acuity in 63 % of patients (in spite of the very low preoperative visual acuity) proves the efficacy and perspectiveness of the recommended surgical approach to the treatment of the traction complications of diabetic proliferative retinopathy in patients with both IDDM and NIDDM. With the purpose of preserving residual visual functions and preventing haemorrhagic complications we performed in most case the safer extrascleral procedure (encircling band) combined with the short - and long- term laser photocoagulation. Anatomical result combined with the preservation of residual visual functions was of great importance for our patients from the point of their psycho - emotional state stability.

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