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Surgical Rehabilitation of Patients with Traumatic Retinal Detachment after Complicated Perforating Injuries of Eye
Imshenetskaya T., Savitch A.,
Belorussian State Medical University, Department of Ophthalmology, Republican Center for Reconstructive Eye Microsurgery (Minsk)
Proliferative vitreoretinopathy (PVR) is the main cause for acute and long - standing visual loss in consequence of posterior eye pole injuries.
Main goal: To determine the optimal surgical approach in treatment of traumatic retinal detachment.
Method: We have analysed the results of the surgical treatment of 93 patients with traumatic retinal detachment who were managed in our hospital from 1997 to 2000. The main reasons of traumatic retinal detachment were: perforating injury of sclera in 25 patients, penetrating corneoscleral injury, external magnetic extraction - 26 patients, double - penetrating eye injuries - 4 patients, in 24 patients the traumatic retinal detachment had been combined with intraocular foreign bodies (IOFB) embedded in the posterior pole.
Results: PVR of A stage had been in 13 patients; PVR B - stage and C2 stage - in 62 patients. In cases of the traumatic retinal detachment without foreign bodies (IOFB) we have preferred scleral buckling procedure. The encircling procedure was performed with a silicone sponge in 18 patients, the encircling procedure combined with scleral buckling was carried out in 22 patients, only scleral buckling was performed in 6 patients. Management of retinal detachment combined with IOFB includes encircling procedure, scleral buckling, pars plana vitrectomy with perfluorocarbon injection, treansvitreal IOFB removal followed by «Nidec» Diode endolaser and gas tamponade (SF6).
Conclusions: The choice of way of surgical treatment of traumatic retinal detachment depends upon the stage of PVR. In traumatic PVR, stage A, B and C2 it is possible to provide only extrascleral surgical approach without vitrectomy. We had obtained the anatomical success and improvement of visual functions in 88,4% of patients.