Аспекты макулярной хирургии у пациентов с патологической миопией

Abstract

Patient with high and ultra-high myopia belong to the one of the most difficult categories for the vitreoretinal surgery because of the morphological features of choroid, retina and vitreomacular interface: axial length over 26 mm, the presence of posterior staphyloma, thinning of choroid, a combination of hypo- and hyperpigmentation of the retina pigment epithelium. Therefore, the improvement of the technique of vitreoretinal surgery in patients with pathological myopia remains relevant. Purpose. To optimize the technique of vitreoretinal surgery in patients with pathological myopia. Material and methods. There are 14 patients (14 eyes) with myopic traction maculopathy against the background of pathological myopia with clinical refraction from 10 to 26 D were under observation. The axial length of the eye averaged 31.23 ± 1.94 mm. All patients underwent microinvasive three-port vitrectomy 25G. In connection with the anatomical features of the myopic eye, special methods of surgical manipulations in the macular region were used. Results. The obtained positive anatomical and functional results of the treatment demonstrated their effectiveness and safety, which made it possible to develop a certain algorithm for surgical manipulations in macular surgery in patients with pathological myopia. Conclusion. The use of non-standard techniques of vitreoretinal surgery, highly specialized tools and methods for visualizing the structures of the central zone of the retina optimizes the results of the treatment of macular pathology in patients with pathological myopia. Keywords: high myopia, traction maculopathy, epiretinal membrane, vitrectomy, cataract