Prospects of two-port vitrectomy in the treatment of patients with epiretinal fibrosis

Abstract

Aim: to evaluate the efficacy and safety of two-port vitrectomy in the treatment of patients with epiretinal fibrosis. Patients and Methods: surgical treatment using a two-port vitrectomy technique was performed in 25 patients (25 eyes) with epiretinal fibrosis. Patients with concomitant retinal pathology (e.g. diabetic or post-thrombotic retinopathy) and glaucoma were not included in the study. Of the total number of patients, 64% (n=16) were women and 36% (n=9) were men. The mean age of the patients was 61±6,4 years. The surgical procedure was based on the developed technology and conducted by the same surgeon in the same clinical setting. The surgical technique included the installation of two ports in the opposite quadrants: in the upper hemisphere for the vitreotome and instruments, and in the lower hemisphere — for the infusion cannula with a built-in endo-illuminator-chandelier as a single light source. Then, vitrectomy was performed according to the classical technique — the vitreous body was removed centrally, followed by membrane staining and membrane peeling, and partial tamponade with an air mixture. Patients were examined on day 1, one and three months after the surgical procedure. They underwent the basic ophthalmic examination, including visometry and tonometry. Optical coherence tomography with retinal image analysis was used to assess the recovery of anatomical parameters. Results: intra- or postoperative adverse events were not reported. All patients had stable anatomical results: the absence of horizontal tractions in the foveal zone and a retinal height reduction to 297±32 μm. The maximum functional effect — a decrease in metamorphopsia expression and an increase in best-corrected visual acuity by 0.48±0.1 vs. that at the baseline was observed 3 months after the surgery. Conclusion: in addition to the classical three-port vitrectomy with xenon focal illuminator, it is possible to use the two-port vitrectomy with a mercury vapor chandelier illuminator. The advantage of this method is the reduction of surgical trauma. Keywords: epiretinal fibrosis, two-port vitrectomy, phototoxicity, tyndallometry. For citation: Borisova D.V., Frolychev I.A., Pozdeeva N.A. Prospects of two-port vitrectomy in the treatment of patients with epiretinal fibrosis. Russian Journal of Clinical Ophthalmology. 2022;22(4):224–227 (in Russ.). DOI: 10.32364/2311-7729-2022-22-4-224-227.