THE IMPORTANCE OF RECONSTRUCTIVE SURGERY ON THE CAROTID ARTERIES FOR OCULAR ISCHEMIC SYNDROME CORRECTION

T.N. Kiseleva, L.N. Tarasova, Al.An. Fokin
Chair of Eye Diseases, Chair of Emergency Medicine and Medicine of Disasters, Urals State Medical Academy for Advanced Training,
Chelyabinsk, Russia

We studied the influence of carotid reconstructive surgery on ocular functions and ocular blood-flow in patients with ocular ischemic syndrome (OIS) in late post-operative period. 180 patients with OIS have been examined; 104 of them suffered from acute form of the disease, 76 patients had primarily chronic type. They had different forms of internal carotid artery (ICA) pathology: in 103 cases monolateral and in 56 cases – bilateral stenosis, in 21 patients ICA was abnormally meandered. Before surgery and in course of 1-2 years after it all the patients were examined on keenness of sight, n. opticus electrophysiological characteristics, contrast sensitivity of the optical analyser and blood-flow in ophthalmic artery (evaluation by Ultrasound triplex scanning of the orbit). After surgery the keenness of sight reliably increased in patients with the acute form of the disease (before surgery: 0.37±0.05; after surgery: 0.52±0.07), there also were the positive dynamics of electrosensitivity threshold (EST) and n. opticus lability (NOL) (before surgery: EST=276.8±38.1 mcA, NOL=28.5±2.1 Hz; after surgery: EST=200.8±26.1 mcA, NOL=34.9±1.2 Hz, p<0.01). The increase of contrast sensitivity of optical analyser was found in 28.8% patients with the acute form and 10.5% patients with the chronic form of OIS. There was blood-flow acceleration in ophthalmic artery and decrease of vasoresistance in both groups of patients. Reconstructive surgery on carotid arteries is the most effective method in management of the acute form of OIS.

KEY WORDS: ocular ischemic syndrome, ophthalmic artery, internal carotid artery, ultrasound triplex scanning, eyeball, orbit.

P. 15-21

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