PERIPHERAL PREVENTIVE LASER COAGULATION OF THE RETINA IN PATIENTS WITH HIGH DEGREE MYOPIA

Abstract

High degree myopia is accompanied by peripheral retinal degeneration, which is often accompanied by the appearance of microtears in thinning areas with the risk of retinal detachment and is difficult to treat, which can subsequently result in irreversible loss of vision. 34 patients (40 eyes) with stable myopia from 16.0 to 24.0 diopters (D) were examined. The study of the fundus of the was carried out under conditions of maximum mydriasis by reverse and direct ophthalmoscopy. The ophthalmoscopic picture of the fundus was extremely diverse. There were some changes in the central and paracentral areas of the fundus in the form of a myopic cone, scleral or pigment sickle, atrophy of the choriocapillary layer of the choroid, and chorioretinal foci. If necessary, for a more detailed study of the identified changes in the periphery, the fundus was additionally examined with a special therapeutic Goldman triangular lens after complete drug-induced cycloplegia and mydriasis, which made it possible to see the most extreme areas of the retina, to identify the presence or absence of peripheral vitreochorioretinal dystrophies (PVCRD), which are often found in high degree myopia. In order to prevent retinal detachment, a two-stage peripheral prophylactic laser coagulation (PPLC) of the retina of retinoschisis, cystic atrophy and retinal tears was performed in 16 patients in 18 myopic eyes: unilateral in 14 (14 eyes), bilateral in 2 - in 4 eyes. The remaining 22 eyes were not procoagulated due to contraindications. The procedures were performed on the diode laser Visulas-532s (green laser). The diameter of the coagulation spot was 200–300 µm, the exposure time was 0.15–0.2 sec. The first stage is the delimitation of areas of the degeneratively changed retina by a barrier of coagulation foci, the second stage is the impact on the degeneration zone itself. The essence of the method of laser coagulation was to strengthen the weak tissues of the retina with a laser beam, with the help of which the so-called "gluing" of the weak points of the retina and its soldering with the underlying tissues is performed. Complications after prophylactic peripheral laser coagulation of the retina were not observed.