411.24 ± 126 μm to 359.86 ± 120.4 μm (p < 0.05), with a subsequent increase in the mean best-corrected visual acuity (BCVA) from 0. 52 ± 0.2 at baseline to 0.71 ± 0.2 (p < 0.05) at the 12-month follow-up. The mean central retinal sensitivity (RS) improved from 11.27 ± 3.8 dB to 13.24 ± 3.2 dB (p < 0.05). In the control group, our results showed similar improvement in respectively, p < 0.05

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Aim: to evaluate the long-term clinical efficacy of the combined (laser plus surgical) minimally invasive technique for rhegmatogenous retinal detachment (RRD). Patients and Methods: treatment results of 41 patients (41 eyes) with local RRD resulting from horseshoe retinal tear were analyzed. All patients underwent wide-field optical coherence tomography (OCT) to localize and measure pathological vitreoretinal adhesions at the site of retinal tear. The next step was a combined laser surgical procedure that included Nd: YAG dissection of pathological vitreoretinal adhesion zone, pneumatic retinopexy (10% C3F8), and barrier laser retinal photocoagulation (LRP) after reattachment. Postoperatively, eye exams were performed after 3 and 7 days, 3, 6, 12, 18, and 24 months. Results: complete reattachment was achieved in 38 patients (92.7%) on day 2 or 3. No reattachment was seen in three patients (7.3%); of them, subretinal gas migration was observed in two patients (4.9%), and partial reattachment was detected in one patient (2.4%) with pseudophakia. Recurrent RRD occurred in 3 patients (7.9%) because of new inferior retinal breaks. In four patients (10.5%), postoperative wide-field OCT of the area of the initial retinal tear performed after reattachment revealed additional pathological vitreoretinal adhesions in the adjacent areas (that were not identified preoperatively). These patients underwent additional LRP around the areas of pathological vitreoretinal adhesions. No recurrent RRDs were seen during follow-up. Conclusion: combined minimally invasive laser surgical technique for local PPDs demonstrated high efficacy (92.7%). This technique was the effective in local retinal detachment resulting from a single superior horseshoe retinal tear in patients with crystalline lens. In some cases, pseudophakia is a technical obstacle to this procedure. Postoperative wide-field OCT is recommended to detect additional pathological vitreoretinal adhesions and to perform LRP around them to reduce the risks of recurrent RRDs greatly. Keywords: rhegmatogenous retinal detachment, optical coherence tomography, Nd: YAG laser retinotomy, vitreoretinal traction. For citation: Doga A.V., Shkvorchenko D.O., Kryl L.A. et al. Long-term outcomes combined minimally invasive laser surgical technique for local rhegmatogenous retinal detachment. Russian Journal of Clinical Ophthalmology. 2021;21(2):63–68. DOI: 10.32364/2311-7729-2021-21-2-63-68.

Rhegmatogenous retinal detachment (RRD) is one of the leading causes of vision loss world-wide. Despite advances in surgical techniques, rates of redetachment and vision loss remain high. Patients with RRD require a secondary surgery approximately 10 – 40% of the time. To achieve a high anatomical result, reduce the risk of reoperations and maintain high visual functions, it is necessary to develop and analyze microinvasive technologies to eliminate the main cause of RRD - the traction component. Purpose. To evaluate the results of microinvasive combined laser-surgical technology for RRD treatment. Material and мethods. The study included 43 eyes of 43 patients who underwent microinvasive laser-surgical technology for rhegmatogenous retinal detachment treatment, which included 3 consecutive steps: 1) YAG-laser excision of the horseshoe tear zone with vitreoretinal adhesion (VRA); 2) pneumatic retinopexy with 12% C3F8 (immediately after the first step); 3) barrier laser photocoagulation after complete retinal attachment (2-3 days after pneumatic retinopexy). The results were evaluated for anatomical efficacy (rates of retinal attachment and the occurrence of recurrent rhegmatogenous retinal detachment), functional efficacy (uncorrected (UCVA) and bestcorrected (BCVA) visual acuity, intraocular pressure (IOP)), and safety of technology (any intra- and postoperative complications). Results. In 40 patients (93%), the retina was attached with one surgical intervention. The success rate was significantly lower in patients with pseudophakia and a large retinal tear after YAG-laser excision of VRA zone. UNCA, BCVA and IOP after microinvasive combined laser-surgical technology was not significantly different from the initial values (p>0,05). Сlinically significant complications included gas migration into the subretinal space and epiretinal membrane formation. Conclusion. Microinvasive combined laser-surgical technology is characterized by high single surgery success rate (93%), preservation of initially high visual functions, a low rate of redetachment (7,5%) and clinically significant complications (7%). Key words: rhegmatogenous retinal detachment, optical coherence tomography, horseshoe tear, YAG-laser retinotomy, pneumatic retinopexy, vitreoretinal traction.

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