Пятилетний опыт применения аутологичной кондиционированной плазмы (АКП) при отслойке сетчатки с центральным разрывом у пациентов с высокой миопией на фоне выраженной стафиломы склеры макулярной области

Abstract

Purpose. To evaluate surgical treatment effectiveness of retinal detachment associated with central retinal tear, in patients with high myopia and severe staphyloma of the sclera of the macular area by closure of the retinal defect with autologous conditioned plasma (ACP) without retinal endolaser coagulation, tamponade with perfluoroorganic compounds and silicone tamponade; to evaluate the possibility of sutureless closure of sclera- and conjunctivotomies under conditions of pneumoretinopexy at the final stage of surgery. Material and methods. Since 2018, 27 patients with rhegmatogenous retinal detachment with a central tear secondary to high myopia and severe staphyloma of the sclera of the macular area have been operated. All patients underwent standard and additional pre- and postoperative examination, including visometry, tonometry, perimetry, A- and B-scanning, microperimetry, laser tindalemetry, optical coherence tomography as well as fundus images had been taken. In all cases, surgery was completed with pneumoretinopexy. Results. Early postoperative period was uneventful in all clinical groups. Complete retinal reattachment and macular tear closure after ACP application without additional retinal endolaser coagulation after air and silicone tamponade was observed in all patients. In the long-term follow-up period up to 60 months, there were no episodes of recurrent retinal detachment or central tear. Best corrected visual acuity was 0.02–0.6. Complete closure of sclera- and conjunctivotomies was achieved without additional suture fixation. In all cases, the vascular pattern of the conjunctiva was intact, there were also no reactive process detected at the site of ACP application. Conclusion. Developed technique of macular tear surgical closure by ACP subretinal and preretinal application made it possible to eliminate need of tamponade with perfluoroorganic compounds and silicone oil. A method of sutureless sealing of sclera- and conjunctivotomies with an air tamponade using ACP has been developed and successfully applied. Key words: autologous conditioned plasma, retinal detachment with macular hole associated with high myopia and scleral staphyloma, sutureless closure of scleral and conjunctival wounds