Анализ результатов хирургического лечения макулярных разрывов с применением PRP-терапии

Abstract

Actuality. Macular hole is a severe pathology of the central zone of the retina with irreversible loss of photoreceptors. There is no conservative treatment for macular hole, only surgery treatment is effective. Vitrectomy is performed followed by endotamponade of the vitreal cavity with a gas-air mixture. Methods of surgical treatment differ in the way of adaptation of the edges of the macular hole. Purpose. Analysis of the results of treatment of macular holes using PRP technology. Material and methods. We observed 10 patients diagnosed with macular hole who underwent microinvasive 25G closed posterior vitrectomy, membranopiling, macularorhexis, tamponade of macular hole with plateletrich plasma, pneumoretinopexy. At admission, the maximum corrected visual acuity ranged from 0.01 to 0.1 in 40 % of patients, 0.2–0.5 in 60 % of patients. Of the 10 cases of macular holes observed: 3 lamellar holes, 2 holes of small diameter (up to 250 microns), 5 large holes (400 microns – 1000 microns). Results. After surgery with the use of PRP therapy, improvement in visual functions was observed in 7 cases, the maximum corrected visual acuity remained unchanged in 2 cases, in 1 case visual impairment was observed due to the development of a postoperative complication in the form of hemophthalmus, which was stopped with enzyme preparations. In all cases, after the operation, the anatomical integrity of the retina was restored, which was assessed by OCT through 1 month after the intervention. Conclusion. Thus, against the background of this therapy, there is an effective closure of the macular hole, a rapid restoration of the integrity of the retinal profile, visual functions, which indicates the effectiveness of the use of PRP in the practice of a vitreoretinal surgeon. Keywords: macular hole, PRP, hemophthalmus, vitrectomy.