Vitreoretinal and Laser Surgery Department

Vitreoretinal and Laser Surgery Department

450092
14 Aurora Street, Ufa

tel: +7 (347) 255-57-17, fax +7(347) 255-30-21 
skype: 
Vireoretinal Department Ufa Eye Research Institute

Today, one of the priorities of the Institute is the development of vitreoretinal and laser surgery. This focus is justified by steady growth of retinal pathology among the working population. Retinal diseases are rather common pathology of the vision, leading to serious complications, and as a result - loss of vision. In the Russian Federation, the diseases of the optic nerve and the retina take 5th place in the structure of ophthalmopathology and make up approximately 6%.
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Pathology of fundus is multifaceted including not only the damage of the retina but also vitreous. As a result, in the Departments of vitreoretinal and laser surgery there are directions of studying development, determining the search for new methods of diagnosis and treatment of various nosologies. 
The perspective and level of the department activity is based not only on the level of qualifications of surgeons, but also on the equipment used in the diagnosis and treatment. The scientific potential of the unit is an important component. And if the clinical division is a tactical basis of functional activity of the department, the scientific - strategic, defining the direction for further development of the Department. The hierarchical structure of the Institute is based on the principles of the symbiotic relationships between departments, including Department of vitreoretinal and laser surgery with clinical structure, and Laser Department, providing outpatient care for patients.

History

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As part of the historical aspect it must be noted that the development of vitreoretinal surgery in the Institute began in 2006, when the research department of vitreoretinal and laser surgery was created on the initiative and under the supervision of the Director, professor M. Bikbov in Ufa Eye Research Institute.

Today the department of vitreoretinal and laser surgery is one of the largest departments of the Institute. Scientific unit solves the main problem of the optimization of therapeutic and diagnostic procedures for diseases of the vitreoretinal interface. The priority areas include diseases associated with damage of the central part of the retina: age-related macular degeneration, and occlusive and diabetic lesions in fovea. Scientific rationale of a problem solution is based on the logical phasing tasks, starting with a study of morphological and functional characteristics of the damaged area, the development and improvement of diagnostic approaches, optimization of surgical treatments of nosology.

Department

Department of vitreoretinal and laser surgery is a highly qualified department of the Ufa Eye Research Institute, which is equipped with the most modern equipment of leading foreign companies (operating microscopes, microsurgical system, lasers), that allow to perform surgery at very high level. 8 professionals are working at the Department whose task is to provide professional specialized eye care patients.

Doctors perform entire spectrum of surgical procedures on the vitreous and the retina. They underwent training in vitreoretinal surgery in leading foreign clinics, in addition, every year they attend scientific conferences, congresses in Russia and abroad with the presentations.

The main focus of the vitreoretinal and laser surgery department is surgical and scientific activities. The full range of operations performed in the department determine the direction of scientific and practical work, participation in international multicenter studies. Today the Department of Vitreoretinal and Laser Surgery is a leader in Russia in providing patients with antivazoproliferative and intravitreal therapy. Annually Doctors of the Department carry out more than 2,000 surgical procedures using angiogenesis blockers. Such high surgical activity is provided by electronic documents, developed by staff of the Department.

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Scientific activity

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Staff of the department carry out research to develop methods of surgical treatment and diagnosis, thereby increasing the effectiveness of treatment of patients with disorders of the retina, the vitreous body, eye injuries and their consequences. Developments including medicines and their formulations, methods for surgical treatment of patients with pathology of the vitreous and retina, ophthalmic surgical instruments, are confirmed by patents of the Russian Federation. Given the severity of the disease, there is a need for a combinative surgical treatment, including combined pathology and anterior segment of the eye. This fact determines the need to develop new methods of cataract surgery in case of damage of ligament apparatus of the lens.




The complexity of the pathology of the vitreous and retina, multidirectionality of surgical treatment identified key research areas:

- Optimization of the surgical treatment of the central area of ​​the retina on the basis of morphological features of macular pathology of patients with age-related macular degeneration.
- A system of complex rehabilitation of patients with the development of macular edema on the background of venous occlusion of the retina.
- System approach therapy and diagnostic of pathology of the macular area of ​​the retina in the background of diabetic retinopathy.
- Justification of intravitreal pharmacotherapy in the differential diagnosis of retinal pathology in patients with vascular disorders based on correlation analysis of morphological and functional changes.
- A comprehensive assessment of the parameters of the macular area with the choice of tactics of surgical treatment of patients with vitreomacular traction syndrome of different genesis.
Study of different surgical techniques for the treatment of macular zone in patients with age-related macular degeneration, diabetic and venous occlusive nosology is underway.

Annually staff of the Department issue more than 100 publications in leading Russian and foreign journals, as well guidelines, monographs. In order to improve the professional skills of ophthalmologists from other regions the staff of the vitreoretinal and laser surgery department provides in-place training.

Annual holding and attending conferences, forums, congresses in Russia and foreign countries demonstrate a high scientific potential of the department. The main scientific achievements are presented and discussed at the scientific-practical conference with international participation "Modern technologies in Cataract and Refractive Surgery-2011" (Moscow, 2011); Scientific and practical conference "Modern technologies of treatment of vitreoretinal pathology" (Moscow, 2012, 2013, 2014); Scientific and practical conference on ophthalmology with international participation "East-West" (Ufa, 2012, 2013, 2014); XXI All-Russia scientific - practical conference with international participation "New Technologies of Eye Microsurgery" (Orenburg, 2012); conference of ophthalmologists "New therapies for macular pathology" (Surgut, 2012); Ophthalmology Congress with international participation, dedicated to the 80th anniversary of the Kazakh Institute of Eye Diseases "Innovative technologies in daily ophthalmic practice" (Almaty, Kazakhstan, 2013); Scientific-practical conference "High-tech medical care for patients with severe vitreoretinal pathology in a multi-speciality hospital " (Moscow, 2013); XXX Congress of the ESCRS | European Society of Cataract & Refractive Surgeons (Milan, Italy, 2012); XXXI Congress of the ESCRS | European Society of Cataract & Refractive Surgeons (Amsterdam, Holland, 2013); EURETINA | European Society of Retina Specialists (Hamburg, Germany, 2013); EURETINA | European Society of Retina Specialists (London, England, 2014), XXXII Congress of the ESCRS | European Society of Cataract & Refractive Surgeons (London, England, 2014). 



Surgical activity

Vitreoretinal surgery includes obligatory removal of the vitreous body (vitrectomy), surgical release of retina through its clearing from scar tissue using a variety of support instruments (collet forceps, scissors, retinospatula), short-term and \ or long-term tamponade of retina with liquid perfluororganic compounds, silicone oils, gases, as well as the performance of laser coagulation.

Specialists of the department perform vitreoretinal interventions in the cases of vitreous opacities, diabetic retinopathy, proliferative vitreoretinopathy, central retinal tears, complicated rhegmatogenous and traction retinal detachments of various origins. The duration of the surgery depends on the severity of the disease and, accordingly, the volume of interventions and averages 15 to 30 minutes. The high speed of the carrying out of most complex operations in ophthalmology is determined by highly qualified surgeons and the availability of modern equipment. The surgery is performed under the supervision of experienced anesthesiologists under local or general anesthesia.

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Multifunctional microsurgical
 ophthalmic system
 Мillennium
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Multifunctional microsurgical
ophthalmic system
Stellaris PC Мillennium
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Multifunctional microsurgical
ophthalmic system
Constellation Vision System


To date, the department of vitreoretinal and laser surgery performed the entire spectrum of vitreoretinal surgeries:

• Vitreoretinal surgery for retinal detachment
• Vitreoretinal surgery for proliferative diabetic retinopathy
• Endoscopic vitrectomy
• Sutureless microinvasive vitreoretinal surgery (25G, 27G)
• Phacoemulsification, lensectomy, aspiration with IOL implantation of different models
• Removal of foreign bodies of any location, regardless of their magnetic properties
• Reconstructive surgery in injuries consequences
• Intravitreal injection of medications
• Macular surgery   

A special feature is the possibility of surgical treatment not only of vitreoretinal pathology, bus also and cataract, which is often a comorbidity. Surgeries in cases of complicated cataract on the background of injuries, risk of luxation to the vitreous cavity are performed in the Department. The possibility of such events requires the need to usage of high-tech medical devices on the basis of a combination of surgeries on the anterior and posterior segments of the eye. 
Department of vitreoretinal and laser surgery minimized the period of treatment due to high functional parameters in the postoperative period.

Department currently has multifunctional microsurgical ophthalmic system Millennium, Accurus, Stellaris PC, Constellation Vision System based on high-tech combined platform.
The close cooperation of scientific and practical activities provides the performing of unique surgeries such as:

- Combined surgery for fibrovascular membrane of low activity in patients with age-related macular degeneration by extraction of fibrous tissue with partial recovery of retinal pigment epithelium; 
- The use of methods of surgical treatment of a hidden neovascular membranes based on exposure to subpigmental zone of leakage and choroidal neovascularisation;
- The technique of intravenous administration of medicines using endovitreal access in the case of venous occlusion of the retina. 

Diagnostic measures

The Institute has all the necessary modern medical devices for the diagnosis of retinal and vitreous diseases. 
Optical coherence tomography (examination of the state of the retina, especially the macula and the optic nerve), fluorescent angiography (Visucam 500), morphometric evaluation of the macular area with the developed software, the exam of the visual fields, ultrasound. Optical coherence tomography of new generation OCT RetinaScan- 3000 (Nidek) allows to significantly extend the study protocol, and increase the accuracy of assessing structures of the fundus through layer-by-layer examination of the internal structure of the retina. In this regard, OCT RetinaScan is widely used in the diagnosis and monitoring, especially in diseases of the macular area of ​​the retina and optic nerve, allowing to obtain quantitative measurements of tissue thickness. 

Facts of Department Life

Staff of the department takes an active part in scientific competitions. “Intraoperative protection of the corneal endothelium" won in the contest for "The best innovative project of the Republic of Bashkortostan - 2011 " award and " New method of intravitreal access" took first place in the competition UMNIK - 2012.

In 2014, the Head of the Department, candidate of medical science R.R. Fayzrakhmanov and senior researcher, candidate of medical science A.L.Yarmukhametova were awarded Grant by the Republic of Bashkortostan for the monograph "Age-related macular degeneration". The presentation of Dr. Rinat Fayzrakhmanov at the international scientific-practical conference «VasKon'14» (Chennai, India) was called the best and presented with commemorative award.

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In 2015 Innovative project of Ufa Eye Research Institute scientists "Drainage for lacrimal surgery" reached the final of the federal competition Startup Village-2015 and was awarded a grant from the Skolkovo Fund, that underlines the recognition of scientific achievements at the international scientific scene.

Since July 2012, the Institute on behalf of the pharmaceutical company "Novartis Pharma AG" (Basel, Switzerland), along with 12 largest clinics in Europe and the US is involved in a multicenter international study «LUMINOUS». The research is aimed at studying the efficacy of ranibizumab on macular edema, and its result will be to identify new directions and indications for the treatment of diseases of vitreomacular interface.

In accordance with the protocol, all patients undergo planned examinations with results fixing at the international registry. Over the entire period of the project more than 400 patients from different countries were examined, 20% of which were registered by our Institute.

According to the assessment of the international system on protocol «LUMINOUS» Institute ranks 11th in the world in the research activity.

Scientific research is based on the global trends of modern ophthalmology. The recognition of the achievements of vitreoretinal surgeons is confirmed by close cooperation with the foreign schools for vitreoretinal surgery. Every two years, the Institute in cooperation with the Professor Ingrid Kreissig, University of Mannheim-Heidelberg (Germany) holds international training courses on vitreoretinal surgery, age-related macular degeneration and ophthalmic manifestations of diabetes with the participation of leading experts in the diagnosis and treatment of retinal diseases. 

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