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Цель. Оценить демографические и клинические характеристики пациентов с отслойкой сетчатки, пролеченных методом лазерной коагуляции, а также результаты их лечения. Материалы и методы. Исследование было проведено на основе данных кафедры офтальмологии учебно-хирургической клиники Азербайджанского государственного медицинского университета. Ретроспективно проанализированы истории болезни 500 пациентов с диагнозом «отслойка сетчатки» методом случайной выборки (по порядковому номеру историю болезни). Лазеркоагуляцию использовали при лечении 106 пациентов. В базу данных этих пациентов вошли их демографические характеристики (возраст, пол) и результаты комплексного обследования (длительность разрыва, площадь, высота, состояние макулы, выраженность пролиферативной витреоретинопатии, локализация разрыва, сопутствующие заболевания глаз). Результаты. 106 пациентов (21,2% с диагнозом отслойки сетчатки) лечились лазерной коагуляцией. В гендерном составе доля мужчин (79,2±3,9%) до 4 раз превышала долю женщин (20,8±3,9%). Их возраст колебался от 9 до 69 лет, средний возраст составил 52,5±1,6 года. Возрастной тип (наиболее распространенный возраст) – 67 лет, медиана – 55 лет. В распределении по возрастным группам первое место занимают пациенты в возрасте 60–69 лет (37,7±4,7%); удельный вес в возрастных группах – 30–39, 40–49, 50–59 лет (соответственно 21,7±4,0; 14,2±3,4; 15,1±1,8%) достоверно не различался (р>0,05). Заключение. Пациенты с диагнозом «отслойка сетчатки», перенесшие операцию лазеркоагуляции, имеют различные характеристики по наиболее важным демографическим (мужчины, количество трудоспособных лиц) и клиническим характеристикам (площадь отслойки охватывает 1-й и 2-й квадранты, легкая форма, преобладающая доля принадлежит пролиферативной витреоретинопатии). В результате лазеркоагуляции анатомическая совместимость сетчатки обеспечивается в 78,3±4,0% случаев в ближайшем послеоперационном периоде, однако полностью устранить осложнения не удается (отслойка сосудистой оболочки, диплопия, повышение внутриглазного давления). Purpose. To evaluate the demographic and clinical characteristics of patients with retinal detachment treated with laser coagulation, and the results of treatment. Materials and methods. It was conducted based on the data of the ophthalmology department of the Teaching and Surgical Clinic of the Azerbaijan State Medical University, and the medical histories of 500 patients with a diagnosis of retinal detachment were retrospectively analyzed by random selection (according to the serial number of the medical history). Laser coagulation was used in the treatment of 106 patients. The database of these patients included their demographic characteristics (age, gender) and the results of a complex examination (duration of the tear, area, height, condition of the macula, severity of proliferative vitreoretinopathy, location of the tear, concomitant eye diseases). Results. In In the surveillance society, 106 patients (21.2% of patients diagnosed with retinal detachment) were treated with laser coagulation. In the gender composition of patients, the proportion of men (79.2±3.9%) is up to 4 times higher than that of women (20.8±3.9%). Their age ranges from 9 to 69, the average age was 52.5±1.6 years. The mode of age (the most common age) was 67 years, and the median was 55 years. In the distribution of patients by age groups, the first place is occupied by patients aged 60–69 (37.7±4.7%), the specific weights of patients in the age groups 30–39, 40–49, 50–59 (respectively 21.7±4,0; 14.2±3.4; 15.1±1.8%) are not significantly different (p>0.05). Conclusion. Patients with a diagnosis of retinal detachment who underwent laser coagulation surgery have different characteristics in the most important demographic (men, the number of able-bodied persons) and clinical characteristics (the area of detachment covers the 1st and 2nd quadrants, the mild form of proliferative vitreoretinopathy has a predominant share). As a result of laser coagulation, the anatomical compatibility of the retina is ensured in 78.3±4.0% of cases in the immediate postoperative period, but complications cannot be completely eliminated (0.9% – choroidal detachment, diplopia, 7.5±2.5% – increase in intraocular pressure increase, 2.8±1.6% – hemophthalmias, 17.0±3.6% – cataracts).
Цель. Оценить демографические и клинические характеристики пациентов с отслойкой сетчатки, пролеченных методом лазерной коагуляции, а также результаты их лечения. Материалы и методы. Исследование было проведено на основе данных кафедры офтальмологии учебно-хирургической клиники Азербайджанского государственного медицинского университета. Ретроспективно проанализированы истории болезни 500 пациентов с диагнозом «отслойка сетчатки» методом случайной выборки (по порядковому номеру историю болезни). Лазеркоагуляцию использовали при лечении 106 пациентов. В базу данных этих пациентов вошли их демографические характеристики (возраст, пол) и результаты комплексного обследования (длительность разрыва, площадь, высота, состояние макулы, выраженность пролиферативной витреоретинопатии, локализация разрыва, сопутствующие заболевания глаз). Результаты. 106 пациентов (21,2% с диагнозом отслойки сетчатки) лечились лазерной коагуляцией. В гендерном составе доля мужчин (79,2±3,9%) до 4 раз превышала долю женщин (20,8±3,9%). Их возраст колебался от 9 до 69 лет, средний возраст составил 52,5±1,6 года. Возрастной тип (наиболее распространенный возраст) – 67 лет, медиана – 55 лет. В распределении по возрастным группам первое место занимают пациенты в возрасте 60–69 лет (37,7±4,7%); удельный вес в возрастных группах – 30–39, 40–49, 50–59 лет (соответственно 21,7±4,0; 14,2±3,4; 15,1±1,8%) достоверно не различался (р>0,05). Заключение. Пациенты с диагнозом «отслойка сетчатки», перенесшие операцию лазеркоагуляции, имеют различные характеристики по наиболее важным демографическим (мужчины, количество трудоспособных лиц) и клиническим характеристикам (площадь отслойки охватывает 1-й и 2-й квадранты, легкая форма, преобладающая доля принадлежит пролиферативной витреоретинопатии). В результате лазеркоагуляции анатомическая совместимость сетчатки обеспечивается в 78,3±4,0% случаев в ближайшем послеоперационном периоде, однако полностью устранить осложнения не удается (отслойка сосудистой оболочки, диплопия, повышение внутриглазного давления). Purpose. To evaluate the demographic and clinical characteristics of patients with retinal detachment treated with laser coagulation, and the results of treatment. Materials and methods. It was conducted based on the data of the ophthalmology department of the Teaching and Surgical Clinic of the Azerbaijan State Medical University, and the medical histories of 500 patients with a diagnosis of retinal detachment were retrospectively analyzed by random selection (according to the serial number of the medical history). Laser coagulation was used in the treatment of 106 patients. The database of these patients included their demographic characteristics (age, gender) and the results of a complex examination (duration of the tear, area, height, condition of the macula, severity of proliferative vitreoretinopathy, location of the tear, concomitant eye diseases). Results. In In the surveillance society, 106 patients (21.2% of patients diagnosed with retinal detachment) were treated with laser coagulation. In the gender composition of patients, the proportion of men (79.2±3.9%) is up to 4 times higher than that of women (20.8±3.9%). Their age ranges from 9 to 69, the average age was 52.5±1.6 years. The mode of age (the most common age) was 67 years, and the median was 55 years. In the distribution of patients by age groups, the first place is occupied by patients aged 60–69 (37.7±4.7%), the specific weights of patients in the age groups 30–39, 40–49, 50–59 (respectively 21.7±4,0; 14.2±3.4; 15.1±1.8%) are not significantly different (p>0.05). Conclusion. Patients with a diagnosis of retinal detachment who underwent laser coagulation surgery have different characteristics in the most important demographic (men, the number of able-bodied persons) and clinical characteristics (the area of detachment covers the 1st and 2nd quadrants, the mild form of proliferative vitreoretinopathy has a predominant share). As a result of laser coagulation, the anatomical compatibility of the retina is ensured in 78.3±4.0% of cases in the immediate postoperative period, but complications cannot be completely eliminated (0.9% – choroidal detachment, diplopia, 7.5±2.5% – increase in intraocular pressure increase, 2.8±1.6% – hemophthalmias, 17.0±3.6% – cataracts).
Purpose. To develop a method of circular buckle length calculation for optimization of circular scleral buckling in retinal detachment surgery.Methods. At the first stage of the study a formula for calculation of optimal circular scleral buckle length for patients with various axial length (AL) of the eyeball was developed (90 eyes). These healthy eyes were divided into three groups, 30 eyes in each: group 1 — AL 19 to 23.5 mm, group 2 — AL 23.6 to 27 mm, group 3 — AL over 27 mm. In all the groups AL and equatorial diameter of the eyeball were measured with ultrasound A- and B- scanning (Тomey UD8000, Tomey AL 3000). Mathematic estimation of equatorial eyeball diameter dependence on AL was performed using correlation and regression analysis and the formula for optimal circular buckle length calculation was derived. At the second stage the derived formula was used in clinic during retinal detachment surgery in 15 eyes of 15 patients aged 28 to 44 years (37.6 ± 2.6) with subtotal retinal detachment occupying 2 to 3 quadrants. Follow-up period was 1 to 4 months (2.3 ± 0.5). For control, in all patient’s intraoperative measurement of the eyeball circumference in equatorial zone was performed.Results. The first step of the study revealed high correlation coefficient (r) between AL and equatorial eyeball diameter in groups 1 and 2, 0.89 and 0.87, respectively. In group 3 correlation coefficient was 0.57 which shows moderate correlation between AL and equatorial eyeball diameter. Group 3 (AL > 27 mm) was not included in deriving the formula for circular buckle length calculation. Finally, regression equation was obtained and the following formula for circular buckle length calculation was derived: L = 0.9π (8.05 + 0.66 AL), where L — circular buckle length, π = 3.14, AL — axial length of the eyeball. At the second stage of the study (eyes with AL less than 27 mm) anatomical attachment of the retina was achieved in all 15 cases (100 %), elevation of the buckle was 1.44 to 1.6 mm (1.5 ± 0.02), circular buckle shortening made 10 % of the initial eyeball diameter. Control measurement of eyeball diameter in equatorial zone coincided with calculated values, that is, equaled the data obtained from presented formula and from preoperative ultrasound measurement of equatorial eyeball diameter.Conclusions. The derived formula for circular buckle length calculation is highly effective for eyes with AL less than 27 mm: provides optimal height of impression roll (approximately 1.5 mm), reduces the risk of postoperative complications, it is simple in use and shortens the operation time. For calculation of circular buckle length for eyes with AL over 27 mm it is reasonable to use the data of preoperative ultrasound A-scan measurement of equatorial diameter of the eyeball.
Purpose – to evaluate the demographic and clinical characteristics and treatment efficiency of patients by vitrectomy due to retinal detachment against the background of combined eye pathologies. The observation was conducted in the Clinic of Educational Surgery of the Azerbaijan State Medical Institute named after A. Aliyev. The case histories of 500 patients diagnosed with retinal detachment against the background of combined eye pathologies were studied by random sampling, 197 of whom underwent vitrectomy. Data on the demographic and clinical characteristics of these patients were collected. Before the operation, visual acuity and intraocular pressure were assessed. Information on registered complications after the operation, the results of optical coherence tomography on day 10 after treatment, as well as visual acuity indicators were provided for in the observation program and obtained in a standard manner for all patients. The obtained results were processed statistically using the "data analysis" package of the Excel program. The collected data were grouped by variants of features, the specific weight of each group and subgroup in the aggregate was calculated. The obtained data showed that in 197 (34.9±2.2%) patients with retinal detachment against the background of combined pathologies who underwent vitrectomy, the gender difference was not significant. The overwhelming majority of patients were admitted for treatment with a great delay. Basically, combined pathologies of the cornea (16.2%), lens (45.2%) and vitreous body (5.3%) prevailed. Combined eye pathologies in patients with retinal detachment during vitrectomy are often complicated by choroidal rupture (4.1%), increased intraocular pressure (7.6%), diplopia (3.6%), hemophthalmos (2.5%) and cataract (22.8%). The main etiologic factors of retinal detachment against the background of combined eye pathologies are myopia (50.3%), eye injuries (30.9%).
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