Хирургическое лечение больших идиопатических макулярных разрывов лепестками внутренней пограничной мембраны с насечками

Abstract

Purpose. To study the results of surgical treatment of patients with large diameter idiopathic macular breaks by the proposed method of closing the defect with inverted petals of the internal limiting membrane with incisions. Material and methods. There were analyzed clinical results of surgical treatment of idiopathic macular breaks (IMB) by closing the defect with inverted lobes of the internal limiting membrane with incisions in 25 patients (25 eyes) between 45 and 63 years old. Men – 11 (44%), women – 14 (56%). Terms of treatment in the hospital since the appearance of changes in visual functions: 6 patients after 1.5-2 years, 19 patients after 6-8 months. Visual acuity at admission was: 0.01 in 4 patients; 0.02 in 5; 0.03 in 5; 0.06-0.09 in 6; 0.1-0.3 in 5. Macular ruptures were stage III, diameter from 450 to 730 microns (on average, 594.52± 114.06 microns). The follow-up period is 3 years. Results. In 25 patients underwent 25G endovitreal intervention with closing of the macular hole with the petals of internal limiting membrane. The visual acuity improvement was observed in 23 patients: up to 0,1 – 0,6 – in 20; up to 0,09 – in 3. In 2 patients visual acuity was 0.01-0.02, this may be due to incomplete closure of the macular opening and the duration of the disease. After 3 years of visual function remained stable. Conclusion. The use of inverted petals of internal limiting membrane in the treatment of large diameter IMB contributes to the closure of the macular breaks and restoration of the anatomical profile of the macular in 92% of cases. The increase of visual acuity up to 0.1 – 0.6 in 80% of cases. The stability of clinical results up to 3 years allows us to recommend this method of treatment in practice.