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Офтальмохирургия. 2020; : 93-99

Cовременные методики хирургического лечения пролиферативной диабетической ретинопатии, осложненной тракционной отслойкой сетчатки

Захаров В. Д., Шкворченко Д. О., Какунина С. А., Норман К. С., Дроздков И. А.

https://doi.org/10.25276/0235-4160-2020-2-93-99

Аннотация

По мере развития витреоретинальной хирургии все большую значимость приобретают проблемы и вопросы, связанные с различными подходами лечения пролиферативной диабетической ретинопатии. В обзоре представлены вопросы патогенеза, эпидемиологии, классификации, хирургического лечения пролиферативной диабетической ретинопатии, а также эволюция методики и ее переход от применения большего операционного доступа к малому. Приведены сведения о существовании операционного доступа через малый калибр, бимануальной методике, видах тампонирующих веществ, применяемых в ходе хирургического вмешательства при данной патологии. Также в обзоре рассмотрены поэтапная хирургическая техника в лечении тракционной отслойки сетчатки, используемые инструменты, включая витреотом, эндовитреальный пинцет, эндовитреальные ножницы и др. Несмотря на достижения в области лечения глазных проявлений сахарного диабета, контроля гликемии, успехи в лазерной хирургии, витреоретинальной хирургии, тракционная отслойка сетчатки остается серьезной проблемой, является причиной низкого зрения у пациентов как с сахарным диабетом 1-го, так и 2-го типа и требует немедленного хирургического вмешательства.
Список литературы

1. Каланов М.Р. Клинико-функциональная оценка эффективности комбинированного витреоретинального вмешательства при пролиферативной диабетической ретинопатии: Дис. … канд. мед. наук. М.; 2019.

2. Zhao X, Xia S, Chen Y. Antivascular endothelial growth factor agents pretreatment before vitrectomy for complicated proliferative diabetic retinopathy: a metaanalysis of randomised controlled trials. J Ophthalmol. 2018;102(8): 1077–1085. doi:10.1136/bjophthalmol-2017-311344.

3. Iyer S, Regan K, Burnham M, Chen С. Surgical Management of Diabetic Tractional Retinal Detachments. Surv Ophthalmol. 2019;64(6): 780–809. doi:10.1016/j.survophthal.

4. Zlotcavitch L, Flynn H, Rachitskaya A. Progression to macula-off tractional retinal detachment after a contralateral intraoperative intravitreal bevacizumab injection for proliferative diabetic retinopathy. Clin Ophthalmol. 2015;9: 69–71. doi:10.2147/OPTH.S69466.

5. Wang Z, Zhao K, Li J, Rossmiller B, Zhao PQ. Four-port bimanual 23-gauge vitrectomy for diabetic tractional retinal detachment. Acta Ophthalmol. 2016;94(4): 365–372. doi:10.1111/aos.12951.

6. Бикбов М.М., Файзрахманов Р.Р., Ярмухаметова А.Л., Каланов М.Р. Современные подходы к хирургическому лечению пролиферативной диабетической ретинопатии. Медицинский альманах. 2015;1(36): 86–89.

7. Stewart M, Browning D, Landers M. Current management of diabetic tractional retinal detachments. J Ophthalmol. 2018;66(12): 1751–1762. doi:10.4103/ijo.IJO_1217_18.

8. Vaziri K, Schwartz SG, Relhan N, Kishor KS, Flynn HW Jr. New Therapeutic Approaches in Diabetic Retinopathy. Rev Diabet Stud. 2015;12(2): 196–210. doi:10.1900/RDS.2015.12.196.

9. Kroll P, Rodrigues E, Hoerle S. Pathogenesis and classification of proliferative diabetic vitreoretinopathy. Ophthalmologica. 2007; 221(2): 78–94. doi:10.1159/000098253

10. Bastion M. Pneumatic retinopexy for treatment of posterior pole detachment following vitreoretinal surgery for diabetic tractional retinal detachment threatening the fovea. J Case Rep. 2012;8: 72. doi:10.1136/bcr-2012-006303.

11. Стебнев С.Д., Стебнев В.С., Складчикова Н.И. Эволюция витрэктомии: от 17-gauge до 27-gauge. Наш первый опыт витрэктомии 27-gauge (Constellation). Точка зрения. Восток – Запад. 2015;1: 156.

12. Cruz-Iñigo Y, Acabá L, Berrocal M.Surgical management of retinal diseases: proliferative diabetic retinopathy and traction retinal detachment. J Ophthalmol. 2014;54: 196–203 doi:10.1159/000360467.

13. Oellers P, Mahmoud T. Surgery for Proliferative Diabetic Retinopathy: New Tips and Tricks. J Ophthalmol. 2016;11(1): 93–99. doi:10.4103/2008-322X.180697.

14. Шкворченко Д.О., Какунина С.А., Белоусова Е.В., Русановская А.В. Техника бимануальной 2729 G витрэктомии в лечении пролиферативной диабетической ретинопатии. Современные технологии лечения витреоретинальной патологии. М.; 2012.

15. Leiderman Y. An Optimized Technique for Peripheral Vitreoretinal Surgery with Chandelier Endoillumination. J Ophthalmol. 2019;24: 101–107. doi:10.1097/IAE.0000000000002474.

16. Berrocal M. All-Probe vitrectomy dissection techniques for diabetic tractional retinal detachments: lift and shave. Retina. 2018;38(Suppl. 1): S2–S4. doi:10.1097/IAE.0000000000001884.

17. Celik E, Sever O, Horozoglu F, Yanyali A. Segmentation and removal of fibrovascular membranes with high-speed 23 G transconjunctival suture less vitrectomy, in severe proliferative diabetic retinopathy. Clin Ophthalmol. 2016;10: 903– 910. doi:10.2147/OPTH.S95145.

18. Ch’ng S, Papayannis A, Stringa F, Tsamis E, Stanga P, Jalil A. The effect of bevacizumab before vitrectomy for diabetic tractional retinal detachment demonstrated on optical coherence tomography angiography. J Curr Ophthalmol. 2018;30(3): 276–279. doi:10.1016/j.joco.2018.06.001.

19. Cruz-Inigo Y, Berrocal M. Twenty-seven-gauge vitrectomy for combined tractional and rhegmatogenous retinal detachment involving the macula associated with proliferative diabetic retinopathy. J Retina Vitreous. 2017;3: 38. doi:10.1186/s40942-017-0091-x.

20. Elwan MM, Hagras SM, Kasem MA. Soloist performance of vitrectomy probe in proliferative diabetic retinopathy. Eur J Ophthalmol. 2019;29(6): 251–256. doi:10.1177/1120672118785103.

21. Falavarjani K, Modarres M, Hadavandkhani A, Moghaddam KA. Intra-silicone oil injection of methotrexate at the end of vitrectomy for advanced proliferative diabetic retinopathy. J Eye (London, England). 2015;29(9): 1199–1203. doi:10.1038/eye.2015.114.

22. Guthrie G, Magill H, Steel D. 23-gauge versus 25-gauge vitrectomy for proliferative diabetic retinopathy: a comparison of surgical outcomes. Ophthalmologica. 2015;233(2): 104–111. doi:10.1159/000369258.

23. Huang C, Hsieh Y, Yang C. Vitrectomy for complications of proliferative diabetic retinopathy in young adults: clinical features and surgical outcomes. Graefes Arch Clin Exp Ophthalmol. 2017;255(5): 863–871. doi:10.1007/s00417-016-3579-4.

24. Michalewska Z, Bednarski M, Michalewski J, Jerzy N. The role of ILM peeling in vitreous surgery for proliferative diabetic retinopathy complications. Ophthalmic Surg Lasers Imaging Retina. 2013;44 (3): 238–242. doi:10.3928/23258160-20130503-05.

25. Jackson TL, Donachie PH, Williamson TH, Sparrow JM, Johnston RL. The Royal College of Ophthalmologists’ National Ophthalmology Database Study of Vitreoretinal Surgery Retina. 2015;35(8): 16151621. doi:10.1097/IAE.0000000000000523.

26. Khan M, Samara W, Hsu J, Garg S. Short-term outcomes of hybrid 23-, 25-, and 27-gauge vitrectomy for complex diabetic tractional retinal detachment repair. Retin Cases Brief Rep. 2019;13(3): 244–247. doi:10.1097/ICB.0000000000000571.

27. Lin S, Yeh P, Huang J, Yang C. Preoperative prognostic factors in vitrectomy for severe proliferative diabetic retinopathy. Taiwan Journal of Ophthalmoly. 2014;4(4): 174–178.

28. Moon H, Lee D, Nam D. Trimanual technique using assistant-controlled light probe illumination and wide-angle viewing system in 23-gauge sutureless vitrectomy for diabetic tractional retinal detachment. Ophthalmic Surg Lasers Imaging Retina. 2015;46(1): 73–76. doi:10.3928/23258160-20150101-12.

29. Mikhail M, Ali-Ridha A, Chorfi S, Kapusta M. Long-term outcomes of suture less 25-Gþ parsplanavitrectomy for the management of diabetic tractional retinal detachment. Graefes Arch Clin Exp. 2017;255(2): 255–261. doi:10.1007/s00417-0163442-7.

30. Sharma S, Hariprasad S, Mahmoud T. Surgical management of proliferative diabetic retinopathy. Ophthalmic Surg Lasers Imaging Retina. 2014;45(3): 188–193. doi:10.3928/23258160-20140505-01.

Fyodorov Journal of Ophthalmic Surgery. 2020; : 93-99

Modern Methods of Surgical Treatment of Proliferative Diabetic Retinopathy Complicated by Traction Retinal Detachment

Zakharov V. D., Shkvorchenko D. O., Kakunina S. A., Norman K. S., Drozdkov I. A.

https://doi.org/10.25276/0235-4160-2020-2-93-99

Abstract

With the development of vitreoretinal surgery, problems and issues related to various approaches to the treatment of proliferative diabetic retinopathy are becoming increasingly important. This review presents the issues of pathogenesis, epidemiology, classification, surgical treatment of proliferative diabetic retinopathy, as well as the evolution of the technique, and its transition from the application of greater surgical access to small. The data on the existence of surgical access through a small caliber, bimanual technique, types of tamponade substances used in the course of surgical intervention in this pathology are given. Also, in this review is considered a phased surgical technique in the treatment of traction retinal detachment, tools used, including vitreous, endovitreal tweezers, endovitreal scissors and others. Despite advances in the treatment of ocular manifestations of diabetes mellitus, glycemic control, advances in laser surgery, vitreoretinal surgery, traction retinal detachment remains a serious problem, causing decreased vision in patients with both type I and type II diabetes, and requires immediate surgical intervention.
References

1. Kalanov M.R. Kliniko-funktsional'naya otsenka effektivnosti kombinirovannogo vitreoretinal'nogo vmeshatel'stva pri proliferativnoi diabeticheskoi retinopatii: Dis. … kand. med. nauk. M.; 2019.

2. Zhao X, Xia S, Chen Y. Antivascular endothelial growth factor agents pretreatment before vitrectomy for complicated proliferative diabetic retinopathy: a metaanalysis of randomised controlled trials. J Ophthalmol. 2018;102(8): 1077–1085. doi:10.1136/bjophthalmol-2017-311344.

3. Iyer S, Regan K, Burnham M, Chen S. Surgical Management of Diabetic Tractional Retinal Detachments. Surv Ophthalmol. 2019;64(6): 780–809. doi:10.1016/j.survophthal.

4. Zlotcavitch L, Flynn H, Rachitskaya A. Progression to macula-off tractional retinal detachment after a contralateral intraoperative intravitreal bevacizumab injection for proliferative diabetic retinopathy. Clin Ophthalmol. 2015;9: 69–71. doi:10.2147/OPTH.S69466.

5. Wang Z, Zhao K, Li J, Rossmiller B, Zhao PQ. Four-port bimanual 23-gauge vitrectomy for diabetic tractional retinal detachment. Acta Ophthalmol. 2016;94(4): 365–372. doi:10.1111/aos.12951.

6. Bikbov M.M., Faizrakhmanov R.R., Yarmukhametova A.L., Kalanov M.R. Sovremennye podkhody k khirurgicheskomu lecheniyu proliferativnoi diabeticheskoi retinopatii. Meditsinskii al'manakh. 2015;1(36): 86–89.

7. Stewart M, Browning D, Landers M. Current management of diabetic tractional retinal detachments. J Ophthalmol. 2018;66(12): 1751–1762. doi:10.4103/ijo.IJO_1217_18.

8. Vaziri K, Schwartz SG, Relhan N, Kishor KS, Flynn HW Jr. New Therapeutic Approaches in Diabetic Retinopathy. Rev Diabet Stud. 2015;12(2): 196–210. doi:10.1900/RDS.2015.12.196.

9. Kroll P, Rodrigues E, Hoerle S. Pathogenesis and classification of proliferative diabetic vitreoretinopathy. Ophthalmologica. 2007; 221(2): 78–94. doi:10.1159/000098253

10. Bastion M. Pneumatic retinopexy for treatment of posterior pole detachment following vitreoretinal surgery for diabetic tractional retinal detachment threatening the fovea. J Case Rep. 2012;8: 72. doi:10.1136/bcr-2012-006303.

11. Stebnev S.D., Stebnev V.S., Skladchikova N.I. Evolyutsiya vitrektomii: ot 17-gauge do 27-gauge. Nash pervyi opyt vitrektomii 27-gauge (Constellation). Tochka zreniya. Vostok – Zapad. 2015;1: 156.

12. Cruz-Iñigo Y, Acabá L, Berrocal M.Surgical management of retinal diseases: proliferative diabetic retinopathy and traction retinal detachment. J Ophthalmol. 2014;54: 196–203 doi:10.1159/000360467.

13. Oellers P, Mahmoud T. Surgery for Proliferative Diabetic Retinopathy: New Tips and Tricks. J Ophthalmol. 2016;11(1): 93–99. doi:10.4103/2008-322X.180697.

14. Shkvorchenko D.O., Kakunina S.A., Belousova E.V., Rusanovskaya A.V. Tekhnika bimanual'noi 2729 G vitrektomii v lechenii proliferativnoi diabeticheskoi retinopatii. Sovremennye tekhnologii lecheniya vitreoretinal'noi patologii. M.; 2012.

15. Leiderman Y. An Optimized Technique for Peripheral Vitreoretinal Surgery with Chandelier Endoillumination. J Ophthalmol. 2019;24: 101–107. doi:10.1097/IAE.0000000000002474.

16. Berrocal M. All-Probe vitrectomy dissection techniques for diabetic tractional retinal detachments: lift and shave. Retina. 2018;38(Suppl. 1): S2–S4. doi:10.1097/IAE.0000000000001884.

17. Celik E, Sever O, Horozoglu F, Yanyali A. Segmentation and removal of fibrovascular membranes with high-speed 23 G transconjunctival suture less vitrectomy, in severe proliferative diabetic retinopathy. Clin Ophthalmol. 2016;10: 903– 910. doi:10.2147/OPTH.S95145.

18. Ch’ng S, Papayannis A, Stringa F, Tsamis E, Stanga P, Jalil A. The effect of bevacizumab before vitrectomy for diabetic tractional retinal detachment demonstrated on optical coherence tomography angiography. J Curr Ophthalmol. 2018;30(3): 276–279. doi:10.1016/j.joco.2018.06.001.

19. Cruz-Inigo Y, Berrocal M. Twenty-seven-gauge vitrectomy for combined tractional and rhegmatogenous retinal detachment involving the macula associated with proliferative diabetic retinopathy. J Retina Vitreous. 2017;3: 38. doi:10.1186/s40942-017-0091-x.

20. Elwan MM, Hagras SM, Kasem MA. Soloist performance of vitrectomy probe in proliferative diabetic retinopathy. Eur J Ophthalmol. 2019;29(6): 251–256. doi:10.1177/1120672118785103.

21. Falavarjani K, Modarres M, Hadavandkhani A, Moghaddam KA. Intra-silicone oil injection of methotrexate at the end of vitrectomy for advanced proliferative diabetic retinopathy. J Eye (London, England). 2015;29(9): 1199–1203. doi:10.1038/eye.2015.114.

22. Guthrie G, Magill H, Steel D. 23-gauge versus 25-gauge vitrectomy for proliferative diabetic retinopathy: a comparison of surgical outcomes. Ophthalmologica. 2015;233(2): 104–111. doi:10.1159/000369258.

23. Huang C, Hsieh Y, Yang C. Vitrectomy for complications of proliferative diabetic retinopathy in young adults: clinical features and surgical outcomes. Graefes Arch Clin Exp Ophthalmol. 2017;255(5): 863–871. doi:10.1007/s00417-016-3579-4.

24. Michalewska Z, Bednarski M, Michalewski J, Jerzy N. The role of ILM peeling in vitreous surgery for proliferative diabetic retinopathy complications. Ophthalmic Surg Lasers Imaging Retina. 2013;44 (3): 238–242. doi:10.3928/23258160-20130503-05.

25. Jackson TL, Donachie PH, Williamson TH, Sparrow JM, Johnston RL. The Royal College of Ophthalmologists’ National Ophthalmology Database Study of Vitreoretinal Surgery Retina. 2015;35(8): 16151621. doi:10.1097/IAE.0000000000000523.

26. Khan M, Samara W, Hsu J, Garg S. Short-term outcomes of hybrid 23-, 25-, and 27-gauge vitrectomy for complex diabetic tractional retinal detachment repair. Retin Cases Brief Rep. 2019;13(3): 244–247. doi:10.1097/ICB.0000000000000571.

27. Lin S, Yeh P, Huang J, Yang C. Preoperative prognostic factors in vitrectomy for severe proliferative diabetic retinopathy. Taiwan Journal of Ophthalmoly. 2014;4(4): 174–178.

28. Moon H, Lee D, Nam D. Trimanual technique using assistant-controlled light probe illumination and wide-angle viewing system in 23-gauge sutureless vitrectomy for diabetic tractional retinal detachment. Ophthalmic Surg Lasers Imaging Retina. 2015;46(1): 73–76. doi:10.3928/23258160-20150101-12.

29. Mikhail M, Ali-Ridha A, Chorfi S, Kapusta M. Long-term outcomes of suture less 25-Gþ parsplanavitrectomy for the management of diabetic tractional retinal detachment. Graefes Arch Clin Exp. 2017;255(2): 255–261. doi:10.1007/s00417-0163442-7.

30. Sharma S, Hariprasad S, Mahmoud T. Surgical management of proliferative diabetic retinopathy. Ophthalmic Surg Lasers Imaging Retina. 2014;45(3): 188–193. doi:10.3928/23258160-20140505-01.