Prof. Dr. Neli Sivkova: We operate on the retina with a mini guillotine

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Prof. Dr. Neli Sivkova: We operate on the retina with a mini guillotine
Prof. Dr. Neli Sivkova: We operate on the retina with a mini guillotine
Anonim

The head of the eye clinic of the University Hospital "St. Georgi" in Plovdiv Prof. Neli Sivkova is among our most respected ophthalmologists abroad. Participates in more than 10 European and world associations. She specialized in Germany and Austria.

Hundreds of Bulgarians owe their sight to Prof. Sivkova, some of them even consider her their second mother. They see the world thanks to her. They were born with multiple foci of malignant tumor in both eyes and their lives were in danger until fate met them with this unique person and doctor.

However, Prof. Sivkova's greatest satisfaction comes from the cured patients. For them, she is not only a professional, but also a good person. It is no coincidence that her name appears in the so-called "white list" of Bulgarian doctors to whom one can entrust one's he alth and life.

Prof. Sivkova, how did the symposium recently organized by your clinic go?

- Innovative eye surgeries were demonstrated to more than 100 ophthalmologists from across the country. For the first time in our country, together with our world-famous guest surgeon from Bucharest, Dr. Florian B alta, we operated on eyes through incisions smaller than half a millimeter - 0.4 mm. We also performed combined surgery, the so-called "two-in-one" operation: cataract removal, senile veil, and seamless vitrectomy - surgery of the retina and vitreous body. The interventions were made with the high-tech Constellation device - a miniature guillotine created specifically for this type of operation.

The patients selected for the demonstration surgery were two women with membranes deforming the center of the retina, two men with macular hole and vitreous fat, and a young man with diabetic eye complications. The duration of each of the operations was about 20 minutes on average, and the majority of them were with local anesthesia. Only the patient with diabetic complications was under general anesthesia.

In what cases can this new method be applied?

- In its form, vitrectomy can be used for the entire spectrum of indications for all previous methods that relied on a larger working opening. The group of indications includes changes in the diabetic eye, including internal bleeding in the eye, which interferes with vision, as well as changes in the retina, which is a very delicate structure - there is a brain device. Another group subject to 27+G vitrectomy are the so-called macular holes - central retinal defects. Membranes can also be operated on - excess tissues that deform the retina and make the image distorted and inaccurate. In practice, with the new method, micron-thick structures can be grasped and removed with a fine instrument passing through an opening as small as 0.4 mm.

This minimal incision is extremely gentle on the patient and on the third day after the operation the eye is restored.

The new seamless technique is without visible trauma to the eye

The method is extremely effective in the hands of a skilled surgeon because the instruments used have a profile that allows the tissue to be touched very delicately so that it is not further traumatized by the doctor.

According to experts, diabetes has become a pandemic in Bulgaria. Are his eye complications severe?

- Diabetes is an insidious disease, there are no cures for it. It wreaks havoc throughout life - as long as the person has it. Diabetes is there before we even know we are sick. Whether it is well controlled or not, it gives its complications. Eye complications are one of the most disabling - imagine a patient who is already half-blind, what a social problem he is for himself, for his family, for society. In Bulgaria, this problem exists because of the lack of prevention of diabetes and eye diseases, there is no screening to detect early complications, so as not to end up with surgery and irreversible conditions.

Not a single program works in our country…

- Yes, that's right, it's a fact. When a diabetic patient goes to his endocrinologist, due to lack of time, there is no way for him to actively remind him to seek a consultation with an eye specialist. There is always an eye problem - whether the diabetes has been for one or 10 years. It damages even before it is clinically manifested… Effective screening for this disease is needed to prevent ocular complications. The fact that a patient can still see well does not mean that everything is fine in the retina, in the vitreous body of the eye! He may have 100% vision and the retina is already damaged.

Many children consider you a second mother - you saved their sight, and they were born with tumors in their eyes. What is the most sinister case that shook you to the core?

- I have so many touching cases in my practice that it is difficult for me to say which one is the most. Now the children are already 15-20 years old.and have residual vision. They managed to be realized and that makes me very happy. But one that deeply touched my heart is of a boy, already 20 years old, now a student, an extremely intelligent child. I took him in as a baby - he had early retinoblastoma. Retinoblastoma is aggressive and there is no time to delay, otherwise the child will lose not only his vision, but also his eyes. One eye was removed immediately, and for the second I fought a very long battle, with almost 15 years of history. He was hospitalized many times in our clinic in Plovdiv, in the German clinic in Essen. In practice, this eye remained as an organ, lost his sight but is alive

Currently following "He alth Management" - I'm proud of it! While he could still see, he had painted me in an impressive picture - a woman with the sun on her forehead. This is how Dilyan saw me - I cried…

Miracles are being told about your 31 year old rescued patient, what happened to him?

- The case was very interesting, eyesight - almost zero. Colleagues do not operate in such a situation. My inner feeling was that he should be given a chance, and maybe after the intervention his vision will not be zero. I did, as I myself call it, "desperation surgery". But to my greatest joy and his, the team and I managed to control the purulent inflammatory process, the foreign body was removed and we achieved quite good vision - at 60%.

9mm metal in the eye - how did you see it?

- To the eye, this is a huge piece of metal… Colleagues from Varna sent it to me, they do not have fine equipment for such a complex intervention. The young man had endured the foreign body in his eye for more than a week, and he had no he alth insurance. When he came, his eye was full of pus, the piece lodged near his optic nerve. He couldn't see anything, didn't react to light. I am happy that I saved his sight…

Tumors in the eyes in which children most often appear?

- Both full-term and premature. This disease has a certain frequency. The risk is high in consanguineous marriages. Among Turks and Roma, the number of children born with eye tumors is significantly higher - they marry into their own family and their children suffer from genetic diseases.

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