A two-stage laser surgery for fibroplastic changes of the vitreous humor
DOI:
https://doi.org/10.31288/oftalmolzh20184710Keywords:
proliferative vitreoretinopathy, laser photocoagulation, Nd-Yag laser vitreolysisAbstract
Background. Patients with profilerative vitreoretinopathy are performed vitrectomy which, however, is challenging in the presence of high visual function, transparent lenses, and single vitreoretinal adhesion bands as well as at risk of hemorrhages.
Purpose. To determine the efficacy of a two-stage laser treatment, including laser photocoagulation (LP) and laser vitreolysis (LV), for vitreoretinal adhesion bands.
Material and Methods. A total of forty-two patients (42 eyes) with fibroplastic changes were treated. Laser interventions were performed in two stages: 1) laser photocoagulation of the retina, in sites where the bands attached the retina, followed by 2) neodymium-doped yttrium aluminum garnet (Nd:YAG) laser vitreolysis. Accurate focusing and adjusting the optimal laser energy contribute to increased treatment efficacy.
Results. At the first stage, 36 patients (86%) were performed preventive LP of newly-formed vessels of the bands and limiting LP in the sites of attachment of the bands and membranes. LP was made in the basement of the vitreoretinal bands in the sites where tractional retinal detachment could occur. At 2-3 weeks, after chorioretinal comissura had been formed, Nd:YAG LV was performed. On treatment completion, visual acuity increased by 27% in 28 patients (67%). In addition, the level of intraocular pressure almost did not change (20.0 mm Hg).
The present treatment managed to dissect the vitreoretinal adhesion bands and to decrease a degree of traction in 38 patients (67%).
Conclusion. The studies showed a high efficacy of a two-stage laser treatment for vitreoretinal adhesion bands which, in certain cases, can be alternative to surgical treatment, vitrectomy and endolaser photocoagulation.
References
Beliaieva MI. [Remote results of laser photocoagulation in patients with vitreoretinal complications of proliferative diabetic retinopathy]. [Proceedings of scientific practical conference "Lasers in ophthalmology: yesterday, today, and tomorrow"]. Moscow; 2009:175-9. Russian.
Ivanov AN, Tankovskii VE. [Nd-YAG laser vitreolysis in patients with vitreous body fibrosis of various geneses]. [Proceedings of scientific practical conference "East-West"]. 2012:212. Russian.
Fankhauser F, Kwasniewska S. Laser Vitreolysis. A review. Ophthalmologica. 2002;2:73-84. https://doi.org/10.1159/000048303
I-Ting Sun, Tsung-Han Lee, Chih-Hsin Chen. Rapid Cataract Progression after Nd:YAG Vitreolysis for Vitreous Floaters: A Case Report and Literature Review. Case Rep Ophthalmol. 2017;8(2):321-5.https://doi.org/10.1159/000477159
Kokavec J, Wu Z, Sherwin JC, Ang AJ, Ang GS. Nd:YAG laser vitreolysis versus pars plana vitrectomy for vitreous floaters. Cochrane Database Syst Rev. 2017 Jun 1;6:CD011676.https://doi.org/10.1002/14651858.CD011676.pub2
Kwon OW, Song JH, Roh MI. Retinal Detachment and Proliferative Vitreoretinopathy. Dev Ophthalmol. 2016;55:154-62. https://doi.org/10.1159/000438972
Liu XY, Nie AG. Q-switched Nd:YAG laser surgery on vitreous traction bands. Zhonghua Yan Ke Za Zhi. 1991;27(3):182-4.
Milston R, Madigan MC, Sebag J. Vitreous floaters: etiology, diagnostics and management. Surv. Ophthalmol. 2016;61:211-27.https://doi.org/10.1016/j.survophthal.2015.11.008
Schulz-Key S, Carlsson JO, Crafoord S. Longterm follow-up of pars plana vitrectomy for vitreous floaters: complications, outcomes and patient satisfaction. Acta Ophthalmol. 2011;89:159-65.https://doi.org/10.1111/j.1755-3768.2009.01682.x
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 П. П. Чечин, К. Г. Драченко, О. В. Гузун, С. К. Драченко
This work is licensed under a Creative Commons Attribution 4.0 International License.
This work is licensed under a Creative Commons Attribution 4.0 International (CC BY 4.0) that allows users to read, download, copy, distribute, print, search, or link to the full texts of the articles, or use them for any other lawful purpose, without asking prior permission from the publisher or the author as long as they cite the source.
COPYRIGHT NOTICE
Authors who publish in this journal agree to the following terms:
- Authors hold copyright immediately after publication of their works and retain publishing rights without any restrictions.
- The copyright commencement date complies the publication date of the issue, where the article is included in.
DEPOSIT POLICY
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) during the editorial process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work with an acknowledgement of its initial publication in this journal.
- Post-print (post-refereeing manuscript version) and publisher's PDF-version self-archiving is allowed.
- Archiving the pre-print (pre-refereeing manuscript version) not allowed.
