High-frequency electric welding of biological tissues versus diode laser photocoagulation as intraoperative retinopexy in vitrectomy for rhegmatogenous retinal detachment
N.N. Umanets, Cand Sc (Med)
Filatov Institute of Eye Diseases and Tissue Therapy, NAMS of Ukraine
Background: It is important to find an alternative retinopexy technique allowing for the exclusion of silicone oil (or gas) tamponade of the vitreous cavity from the vitrectomy procedure for rhegmatogenous retinal detachment (RRD).
Materials and Methods: A retrospective non-randomized study was conducted and included 112 patients (112 eyes) with uncomplicated RRD. Retinopexy in the study group (53 patients, 53 eyes) and in controls (59 patients, 59 eyes) was performed using high-frequency electric welding of biological tissues (HFEWBT) and 810-nm laser irradiation, respectively.
Results: Mean visual acuity increased to higher levels in the HFEWBT group than in controls at 2 months (0.29 versus 0.21, P = 0.035; this is due to the fact that we managed to avoid intraoperative tamponade in 30% of patients of the study group, thus enabling maintenance of clarity of the posterior lens capsule) and 12 months (0.41 versus 0.39, P > 0.05).
Conclusions: High-frequency electric welding of biological tissues (a) is a safe and efficient method for obtaining a firm chorioretinal adhesion, (b) can be used in the clinical practice for intraoperative retinopexy at the time of vitrectomy in patients with uncomplicated RRD, and (c) can ensure retinal re-attachment at the long-term follow-up in as much as 96% of such cases.
Key words: high-frequency electric welding of biological tissues, retinal detachment, vitrectomy
1.Mitry D, Charteris DG, Fleck BW, et al. The epidemiology of rhegmatogenous retinal detachment: geographical variation and clinical associations. Br J Ophthalmol. 2010 Jun;94(6):678-84
2.Kovalev AI. [Transvitreal surgery for prevention and treatment of traumatic retinal detachments: clinical studies]. [Cand Sc (Med) Thesis]: Odessa: Filatov Institute of Eye Disease; 1987. 194 p. Russian
3.Shishkin MM, Kulikov AN, Churashov SV. [Modern vitreous and retinal detachment surgery]. In: [Danilichev VF, editor. Modern ophthalmology: A guide for doctors]. St Petersburg: Piter; 2000. p340-86. Russian
4.Heimann H., Bartz-Schmidt KU, Bornfeld N, et al. Scleral buckling versus primary vitrectomy in rhegmatogenous retinal detachment: a prospective randomized multicenter clinical study. Ophthalmology. 2007 Dec;114(12):2142–54
6.Zauberman H. Tensile strength of chorioretinal lesions produced by photocoagulation,diathermy, and cryopexy. BrJOphthalmol. 1969;53:749-752
7.Kita M, Negi A, Kawano S, et al. Photothermal, cryogenic, and diathermic effects of retinal adhesive force in vivo. Retina. 1991;11(4):441-4.
8.Yoon YH, Marmor MF. Rapid enhancement of retinal adhesion by laser photocoagulation. Ophthalmology. 1988 Oct;95(10):1385-8
9.Chang S, Lincoff HA, Coleman DJ, et al. Perfluorocarbon gases in vitreous surgery. Ophthalmology. 1985 May;92(5):651-6
10.Hilton GF, McLean EB, Brinton DA, Eds. Retinal Detachment: Principles and Practice. 2nd ed. American Academy of Ophthalmology: San Francisco; 1995
11.Lincoff H, Weinberger D, Stergiu P. Air travel with intraocular gas. II. Clinical considerations. Arch Ophthalmol. 1989 Jun;107(6):907-10
12.Charles S. Vitreous microsurgery. Baltimore: Williams & Wilkins; 1987
13.Honavar SG, Goyal M, Majji AB, et al. Glaucoma after pars plana vitrectomy and silicone oil injection for complicated retinal detachments. Ophthalmology. 1999 Jan;106(1):169-76
14.Pasyechnikova N, Rodin S, Naumenko V, et al. Pilot experimental investigation of the electric welding for the retinopexy . 9th EURORETINA congress, 5-7 May, 2009, Nice, France
15.Pasyechnikova NV, Umanets NN, Artemov AV, et al. [High-frequency electric welding of the tissues of the eyeball posterior part (modified generator EK-300M1) with the application of the original mono- and bipolar set of instruments]. Oftalmol Zh. 2012;2:45-9
16.Umanets NN, Pasyechnikova NV, Naumenko VA, Ptashchenko FA. [Determination of electric current threshold parameters for high-frequency electric welding of the retina in experiment and based on two-dimensional numerical simulation depending on the intraocular contents (vitreous, perftordekalin, air)]. Oftalmol Zh. 2013;5:83-8