The object - rhaegmatogenous retinal detachment, Hipple-Lindau syndrome, uveal melanoma. The purpose of the study: to increase the efficacy of surgical treatment of patients with vitreoretinal pathology on the basis of studying the mechanisms of action of high-frequency electric current on the metabolism and structure of the eye through the development of original instruments, the methods of it’s operational application and introduction in vitreoretinal surgery. Methods of research: light and electron microscopy of retinal and vascular preparations, dynamometer for determining the strength of the chorioretinal complex in rabbits, mathematical modeling of the processes of heating the retina and adjacent tissues under the influence of high-frequency electrical welding of biological tissues by the finite element method in the application PDEToolbx of the MATLAB program; ophthalmologic examination: visometry, biomicroscopy (slit lamp Alcon SL 1000), binocular ophthalmoscopy (Heine Omega 500 ophthalmoscope), optical coherent tomography (Optical Tomography Stratus 3000, CarlZeiss). Methods and of information technology - statistical processing and analysis.
Modified generator EC-300M1 and developed endoviteral welding probes for vitreoretinal surgery. In the model of intraocular bleeding it was established that the effect of high-frequency electric current with frequency 66 kHz at a voltage of 18-20 V, current up to 0.1 A, exposure 1-2 seconds allows to stop bleeding in 67% of cases. The threshold parameters of electric current for high-frequency welding of the chorioretinal complex with tamponade of the vitreous cavity with perfluorodecaline or air (voltage 20-22 V, current up to 0,3 A, frequency 66 kHz), which is fundamentally different voltage level (more on 6 V) from the welding parameters in the presence of a vitreous. The use of high-frequency electric current (voltage 20-22 V, current up to 0,3 A, frequency 66 kHz, exposure to 1,0 s) for retinopexy with vitrectomy in patients with rhegmatogenous retinal detachment allows to exclude endotamponade of the vitreous cavity with gas-air mixture in 30% cases. The use of high-frequency electric current (voltage 24-30 V, current up to 0,3 A, frequency 66 kHz, exposure to 1,0 s) during endoresection of angioma in patients with Hippel-Lindau syndrome in all cases can avoid bleeding from the vessels as a result of the obliteration of the feeder vessels in the contact zone of the welding probe. The method of endovitreal resection of choroidal melanoma with the use of high-frequency electric current (voltage 24-30 V, current up to 0,3 A, frequency 66 KHz, exposure to 1,0 s) allows to achieve haemostasis in 100% of cases and to avoid intraoperative bleeding. The results of the study are introduced into the clinical practice of the Department of Vitreoretinal and Laser Surgery of the SI "Filatov Institute of Eye Diseases and Tissue Therapy NAMS of Ukraine ". Scope – medicine, ophthalmology.
