FIELD: medicine.
SUBSTANCE: ophthalmoscopy to identify the rupture, determine its location and shape, as well as the presence of a local retinal detachment; ultrasound B-scannig to detect the posterior vitreous detachment (PVD), determine its shape and acoustic density (AD) of vitreal tractions in % of sclera AD in an intact site taken as 100%; spectral optical coherence tomography (SOCT) to determine the amount and fixation of vitreals traction to rupture are performed. If ophthalmoscopy reveals a peripheral valvular retinal rupture with a local retinal detachment, according to the ultrasound B-scanning data, the presence of an incomplete PVD with vitreal AD tractions of more than 40% is revealed, according to the SOCT data, single vitreal tractions with fixation to the retinal valve are determined, then barrier laser coagulation of rupture and - in 2-3 weeks - IAG laser vitreolysis of vitreal tractions are prescribed. If ophthalmoscopy reveals a peripheral valvular retinal rupture with a retinal local detachment, and according to ultrasound B-scannig data, an incomplete PVD with vitreal AD tractions of more than 40% is revealed, according to the SOCT data, single vitreal tractions with fixation only in the retinal valve apex, barrier laser coagulation of rupture and - in 2-3 weeks - IAG laser cutting of the retinal valve apex are prescribed. If ophthalmoscopy reveals a peripheral valvular retinal rupture with a local retinal detachment, according to the ultrasound B-scanning data, the presence of an incomplete PVD with vitreal AD tractions of 10 to 90% is revealed, according to the SOCT data, multiple vitreal tractions with fixation over the entire valve area are determined, barrier laser coagulation of rupture and - in 2-3 weeks - IAG laser retinotomy of the valve base with complete clipping are prescribed.
EFFECT: method allows to eliminate vitreal tractions and eliminate traction from the vitreous body while minimizing the volume of IAG laser intervention, which leads to a reduction in the risk of intraoperative complications.
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