Динамика изменений микропериметрических параметров сетчатки при различных методиках закрытия макулярных разрывов на основе аутопластики внутренней пограничной мембраны

Abstract

Currently, vitreoretinal surgery is one of the most effective methods of treating macular holes that can improve the quality of vision, and the most common method of such treatment is vitrectomy with the removal of the internal border membrane around the rupture and the use of autoplasty of the internal border membrane. Microperimetric retinal testing measures the sensitivity of the retina at certain points on a larger surface and detects relative or absolute microscotomas, which allows you to objectively assess the state of the central part of the retina. At the same time, the search for ways to reduce the risk of macular surgery complications and improve functional results continues. Purpose. To propose a new technique for macular tear surgery, which is based on autoplasty of the VPM and reduction of microtraumatization of the retinal layers. Material and methods. The results of surgical treatment of 240 patients (240 eyes) with a diagnosis of macular holes were analyzed. All patients underwent surgical treatment for MH. Depending on the method of closing the macular hole, the patients were divided into two groups: group 1 – patients who underwent surgical treatment using the standard introverted flap technique. Group 2 – patients who were operated on according to the original method with partial peeling of ILM in the macular area. All parameters in the preoperative period were statistically comparable. Results. The most significant are the results obtained on the 30th day after surgical treatment. According to the results of surgical treatment, there was a significant excess of light sensitivity parameters in the nasal part of the pattern used: the upper-nasal and lower-nasal quadrants, where peeling was not performed. Conclusion. During this technique, there is a preservation ILM, which reduces the risk of intraoperative damage to the retinal layers. A higher functional result was obtained. Key words: microperimetry, macular rupture, ILM peeling.