Use of Autologous Conditioned Platelet Rich Plasma in the Surgery of Rhegmatogenous Retinal Detachment with Central and Peripheral Tears

Background. The method of the use of autologous conditioned platelet rich plasma is a promising method in the surgery of retinal pathology, particularly in the surgery of rhegmatogenous retinal detachment without the use of additional endolaser photocoagulation, but requires the foundation of its efficiency.

Aim: to evaluate the effectiveness of the surgery of rhegmatogenous retinal detachment with central (macular) and peripheral retinal tears, including retinal abruption from the dentate line, with the use of 25, 27-gauge subtotal vitrectomy, pneumoretinopexy and silicone oil tamponade with blocking of retinal defect with the use of autologous conditioned plasma without the use of endolaser photocoagulation around retinal defects.

Materials and methods. The surgery included 25, 27-gauge vitrectomy, posterior hyaloid membrane removal, internal limiting membrane removal in case of macular hole, pneumoretinopexy, instiilation in 2–3 layers of autologous conditioned platelet rich plasma, devoid of leukocytes and containing 1.5–3 times more thrombocytes than in whole blood into the area of retinal detachment or along the edge of retinotomy till the retinal defect and nearby intact retina are totally covered. A total of 29 patients with visual acuity from 0.03 to 1.0 underwent the surgery.

Results. In the early postoperative period (up to 1 month) 96.6 % of patients showed total retinal reattachment, retinal detachment was blocked, in one patient with multiple retinal tears recurrent retinal detachment was detected; in the early delayed postoperative period (1–3 months) 82.8 % of patients showed total retinal reattachment, in 5 patient retinal reattachment was partial.

In the late postoperative period (4–12 months) 86.2 % of patients showed total retinal reattachment, there were 4 recurrent retinal detachments. Patients with recurrent retinal detachment were successfully reoperated. Autologous conditioned plasma was not used during reoperations. Visual acuity of the patients, which underwent surgery in the late postoperative period, was 0.1–1.0.

Conclusions. 25, 27-gauge vitreoretinal surgery of rhegmatogenous retinal detachment with central and peripheral retinal tears, including tears with abruption from the dentate line and retinal defects blocking with the use of autologous conditioned plasma rich with thrombocytes without the use of endolaser photocoagulation around retinal defects – is a method which allows to achieve in most cases total retinal reattachment, better functioning of the operated eye.

1. Shkvorchenko DO, Zakharov VD, Kakunina SA, Belousova EV, Rusanovskaya AV, Norman KS, et al. Modern approaches to surgical treatment of rhegmatogenous retinal detachment. Kataraktal’naya i refraktsionnaya khirurgiya. 2015; 15(2): 4-10. (In Russ.)

2. Charles S., Calzada J., Wood B. Vitreous Microsurgery. Transl. Agafonov AA. M.: MEDpress-inform; 2012. (In Russ.)

3. Lyskin PV, Zakharov VD, Zgoba MI. The effect of endolasercoagulation on the postoperative period in patients with retinal detachment. Sovremennye tekhnologii v oftal’mologii. 2017; (1): 173-176. (In Russ.)

4. Pashtaev NP, Arsyutov DG. The use of medical adhesives in surgery of progressive myopia and retinal detachment. Fyodorov Journal of Ophthalmic Surgery. 2009; (3): 16-20. (In Russ.)

5. Achkasov EE, Bezuglov EN, Ulianov AA, Kurshev VV, Repetyuk AD, Egorova AN. Application of platelet-rich plasma in clinical practice. Biomedicine. 2013; (4): 46-59. (In Russ.)

6. Nikolidakis D, Jansen J. The biology of platelet-rich plasma and its application in oral surgery: Literature Review. Tissue Engineering Part B: Reviews. 2008; 14(3): 249-258. doi: 10.1089/ten.teb.2008.0062

7. Arsyutov DG. The use of platelet-rich plasma in surgery of rhegmatogenous retinal detachment. Sovremennye tekhnologii v oftal’mologii. 2018; (1): 32-34. (In Russ.)

8. Shkvorchenko DO, Zakharov VD, Shpak AA, Krupina EA, Pismenskaya VA, Kakunina SA, et al. Our experience with platelet-rich blood plasma in macular tear surgery. Sovremennye tekhnologii v oftal’mologii. 2016; (1): 245-246. (In Russ.)

9. Zhomova MV. The use of autologous serum for osteoarthritis of the knee. Extended abstract of candidate of medical sciences dissertation. Yaroslavl, 2011. (In Russ.)