Tesi etd-05112022-172524 |
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Tipo di tesi
Tesi di dottorato di ricerca
Autore
LOIUDICE, PASQUALE
URN
etd-05112022-172524
Titolo
LOCALIZED VERSUS 360° INTRAOPERATIVE LASER RETINOPEXY IN CASES OF RHEGMATOGENOUS RETINAL DETACHMENT WITH MILD-TO-MODERATE GRADEPROLIFERATIVE VITREORETINOPATHY
Settore scientifico disciplinare
MED/30
Corso di studi
FISIOPATOLOGIA CLINICA
Relatori
tutor Prof. Figus, Michele
correlatore Prof. Nardi, Marco
correlatore Prof. Nardi, Marco
Parole chiave
- 360 degrees endolaser
- Air tamponade
- Circumferential endolaser
- Laser retinopexy
- Localized endolaser
- Retinal detachment
- Vitrectomy
Data inizio appello
01/04/2022
Consultabilità
Non consultabile
Data di rilascio
01/04/2025
Riassunto
Rhegmatogenous retinal detachment is a serious and sight-threatening condition in which neurosensory retina separates from the retinal pigment epithelium and is associated with retinal ruptures that allow vitreous to accumulate in sub-retinal space.
At present, pars plana vitrectomy is the most frequently performed technique for the treatment of rhegmatogenous retinal detachment. Its increasing use in recent years is attributable to various factors resulting from technological progress, including improvements in fluid dynamics, the production of small-gauge instrumentation, and the commercialization of intraocular tamponades (perfluorocarbon liquid, silicone oils, and gases).
Laser photocoagulation is commonly used to ensure adherence between retinal pigment epithelium and neurosensory retina. Circumferential argon laser photocoagulation was also performed to prevent retinal detachment in eyes with lattice degeneration and/or retinal breaks.
During retinal detachment surgery, once the retinal breaks have been identified and the retina has been reattached, the surgeon has two treatment options: to perform extensive 360° laser retinopexy or to apply localized laser photocoagulation just encircling the ruptures, sparing all the remaining retina. Which of the two is the best approach is still a matter of debate and no clear answers have been reported in the literature.
I aimed the compare the efficacy of the two techniques and the respective primary success rate.
This is one of the first prospective studies that aimed to compare intraoperative localized and circumferential laser retinopexy in eyes with RRD treated with PPV and air tamponade.
At present, pars plana vitrectomy is the most frequently performed technique for the treatment of rhegmatogenous retinal detachment. Its increasing use in recent years is attributable to various factors resulting from technological progress, including improvements in fluid dynamics, the production of small-gauge instrumentation, and the commercialization of intraocular tamponades (perfluorocarbon liquid, silicone oils, and gases).
Laser photocoagulation is commonly used to ensure adherence between retinal pigment epithelium and neurosensory retina. Circumferential argon laser photocoagulation was also performed to prevent retinal detachment in eyes with lattice degeneration and/or retinal breaks.
During retinal detachment surgery, once the retinal breaks have been identified and the retina has been reattached, the surgeon has two treatment options: to perform extensive 360° laser retinopexy or to apply localized laser photocoagulation just encircling the ruptures, sparing all the remaining retina. Which of the two is the best approach is still a matter of debate and no clear answers have been reported in the literature.
I aimed the compare the efficacy of the two techniques and the respective primary success rate.
This is one of the first prospective studies that aimed to compare intraoperative localized and circumferential laser retinopexy in eyes with RRD treated with PPV and air tamponade.
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