Вітректомія та ендорезекція ускладнених випадків  вазопроліферативних пухлин сітківки із застосуванням  високочастотного електрозварювання біологічних тканин  (серія клінічних випадків)

M.M. Umanets; I.P. Dovgan; M. I. Marushchak; I.Y. Krynytska

doi:10.31288/oftalmolzh202421318

Authors

M.M. Umanets SI "The Filatov Institute of Eye Diseases and Tissue Therapy of the NAMS of Ukraine"
I.P. Dovgan SI "The Filatov Institute of Eye Diseases and Tissue Therapy of the NAMS of Ukraine" https://orcid.org/0000-0001-8204-1436
M. I. Marushchak I. Horbachevsky Ternopil National Medical University
I.Y. Krynytska I. Horbachevsky Ternopil National Medical University

DOI:

https://doi.org/10.31288/oftalmolzh202421318

Keywords:

vasoproliferartive tumor, high-frequency electric welding of biolohical tissues

Abstract

Background: The relative rarity of retinal vasoptoliferative tumors has resulted in a lack of ecidence-based consensus agreement on how best to treat these lesions. Therefore, there is a need for advanced techniques capable of more effective treatment of these tumors and allowing for the preservation of visual function.

Purpose: To review the results of treatment of large retinal VPTs by pars plana vitrectomy with tumor endoresection and the use of high-frequency electric welding (HFEW) for achieving hemostasis.

Material and Methods: We reivewed the results of surgical treatment of large retinal VPTs complicated by exudative retinal detachment, macular edema, and/or epiretinal fibrosis in 5 patients (6 eyes).

Patients underwent a comprehensive eye examination (visual acuity, biomicroscopy, ophthalmoscopy, tonometry, perimetry) and imaging (ultrasound examination, and optical coherence tomography. Outcome measures included anatomical success (retinal re-attachment), visual acuity, the presence of intraoperative and postoperative hemorrhagic complications, resorption of subretinal exudates, restoration of retinal profile, and the absence of tumor recurrence over the 6-month follow-up period.

Results: Total tumor removal was achieved in all cases. In addition, there was no intraoperative hemorrhage. At the 6-month follow-up examination, the best-corrected visual acuity (BCVA) ranged from 0.17 to 0.3. Over the 6-month follow-up period, the retina remained re-attached, BCVA improved, and partial resorption of hard exudates as well as restoration of the retinal profile was observed in all cases (6 eyes). Moreover, no tumor recurrence was noted.

Conclusion: Vitrectomy with retinal VPT endoresection results in positive anatomical and functional outcomes, making it a method of choice in the treatment of large complicated retinal VPT resistant to more eye-sparing modalities; the HFEW technique proved to be an apt choice for intraoperative hemostasis.

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