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A. Berezovskaya, I.V. Zapuskalov; Treatment of Severe Retinal Detachment Using Endocircle Nickelid Titanium Implants . Invest. Ophthalmol. Vis. Sci. 2003;44(13):2971.
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Purpose: To determine the indications for intraocular fixation of the retina by Nickelid Titanium (Ti-Ni) endocircling implant. Methods: Surgery was performed on 142 eyes of 142 patients with severe retinal detachments (chronic reoccurring PVR retinal detachments, long-standing open or closed funnel retinal detachments) of different etiologies. In all patients a pars plana vitrectomy and epiretinal membrane peeling were performed. The vitrectomy and reattachment procedures were performed under the infusion of air at a pressure of 60 mm of mercury. If it was not possible to flatten the retina under air, the Ti-Ni encircling wire designed for intraocular retinal fixation was implanted. The endocircling wire has the shape of a semi-ring with a diameter of 1.15 mm. Specially developed technology and instruments for the implantation were used. The implant was placed inside the eyeball parallel to the retina break or it was placed across the retinal defect. If the desired result was not achieved an additional wire was implanted. At the conclusion of surgery, all eyes had silicone oil (centistokes 1000) injected into the vitreous cavity to replace the air. Results: Retinas were attached completely, or almost completely, in 121 patients. In 15 patients the Ti-Ni encircling wire has permitted partial retinal reattachment. In 8 patients the retina was too rigid and attachment was not achieved due to severe vitreoretinal fibrosis. Ti-Ni endocircling wires are tolerated well by ocular tissues. The wires do not become displaced and there are no changes in its shape over time. Due to its elastic properties, the Ti-Ni wire supports compression of the retina, does not crush the retina, and prevents silicone from leaking beneath the retina. All patients have been followed between 3 and 5 years. Conclusions: Surgical treatment with Ti-Ni endocircling wire permits us to extend the possibilities for treatment of severe retinal detachments. The results of our clinical observations support the indications for this technology in operating upon complex retinal detachments due to: (1) giant retinal and ora serrata tears with inversion of the torn retinal rag; (2) combinations of giant retinal tears and ora serrata tears with PVR; (3) previously unachieved retinal detachment or recurrent retinal detachments after retinal detachment surgery.
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