Хирургическое лечение центральной отслойки сетчатки с макулярным разрывом у пациентов с высокой миопией и стафиломой склеры

Abstract

Purpose. To analyze the results of surgical treatment of central retinal detachment against the background of macular holes of various diameters in patients with high myopia and scleral staphyloma using autologous conditioned plasma (ACP) as a hole blocking composite and pneumoretinopexy as the final tamponade. Methods. Surgical tactics included subtotal vitrectomy 25 +, 27G, peeling of the inner limiting membrane, pneumoretinopexy, introduction of ACP into the area of scleral staphyloma through the macular hole, and, after the formation of a plasma seal at the base, application of ACP to the surface of the retina in the area of the hole in 2–3 layers up to formation of a resistant ACP layer. The operation was completed seamlessly, blocking the sclero-conjunctival access by applying 2–3 layers of ACP to the surface of the sclera and conjunctiva. Using this technique, 22 patients with central retinal detachment and macular hole with a diameter of 700–2200 microns against the background of high myopia and severe scleral staphyloma were operated. Results. In the early and late postoperative period, the retina was completely attached, and the macular hole was blocked in all patients. Conclusion. This technique is the most sparing and highly effective; it allows the achievement of full anatomical attachment of the retina and closure of the macular hole, eliminates the need for silicone tamponade, minimizes the risk of postoperative complications in patients with central retinal detachment and macular holes of various diameters against the background of high myopia and scleral staphyloma. Key words: central retinal detachment with macular hole; high myopia; scleral staphyloma; autologous conditioned plasma.