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A Berezovskaya, IV Zapuskalov, VN Hodorenko; Complex Surgical Treatment of Severe Retinal Detachment Using Endocircle Nickelid Titanium Implants . Invest. Ophthalmol. Vis. Sci. 2002;43(13):649.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose:To determine on the basis of clinical study the indications for intraocular fixation of the retina by endocircle Nickelid Titanium (Ti-Ni) implant. Methods: The surgery was performed in 87 patients with retinal detachment of different etiology. All patients had a combination of retinal detachment and proliferative vitreoretinopathy (PVR). 52 patients had combined retinal detachment and PVR with giant retinal and ora serrata tears. All patients have had a vitrectomy performed with epiretinal membranes peeling as it was possible. The vitrectomy and retinal attachment were made under infusion of sterile air into the eyeball. If the straightening of the retina was impossible to achieve in the air infusion the endocircle Ti-Ni wire for intraocular retinal fixation was implanted. Endocircle wire has a shape of semi-ring with diameter 1.15 mm. Specially developed technology and instruments for the implantation were used. Deposition of the implant was parallel to the retinal break or it was conducted across the retinal defect. If the desirable result was not achieved the additional wire was implanted. In all cases the surgery was finished by silicone oil injection into the vitreous cavity. Results: Retina was attached completely or almost completely in 64 patients. In 15 patients the implantation of endocircle wire has allowed to achieve partial retinal attachment. In 8 patients retina turned out to be rigid and the attachment was not achieved due to the severest vitreoretinal fibrosis. Ti-Ni endocircle wire is taken good by ocular tissues. Displacement of the wire or changes of its shape were not observed. Due to its elastic properties the wire supports even compression of the retinal rag, does not crush the retina and prevents from silicone leaking under the retina. Conclusion: Surgical treatment with Ti-Ni endocircle wire allows to extend the possibilities of treatment the severe retinal detachment. The results of clinical observations have given definite indications for the technology of complex surgical treatment of severe retinal detachment: 1. Giant retinal and ora serrata tears with inversion of the torn retinal rag. 2. Combination of aforesaid disease with developed PVR. 3. Unachieved attachment of the retina or recurrence of retinal detachment after retinal detachment surgery.
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