Морфофункциональные результаты хирургического лечения эпиретинального фиброза: сравнительный анализ

Abstract

Background. In the last decade, there has been a widespread discussion about the need for ILM peeling. The main argument in favor of ILM removal is that ILM can serve as a framework for cell proliferation, and complete removal of ILM for prevention of ERM recurrence in future is required. On the other hand, the removal of ILM causes damage to Muller cells, which leads to complications such as microscotomas, paramacular holes and dissociation of nerve fiber layers. Purpose of the current study is to compare the functional and anatomical results of various methods of ERM removal. Methods. 75 patients with the diagnosis of epiretinal membrane were operated at the Center of Ophthalmology of NMHC named after N.I. Pirogov. All the patients were divided into 3 groups. Patients of the first group were operated on by the standard method of membrane removal and ILM peeling. The 2nd group included patients operated with the use of ERM removal without removal of ILM. The 3rd group included patients operated according to the original technique with the formation of «notches» in the ILM. All the patients in the pre- and postoperative period (1, 3, 6, 12 months after surgical treatment) underwent complete ophthalmological examination. Conclusion. The results of our study have shown that the technique of ERM surgical treatment without ILM peeling gives higher functional results compared to the group where peeling was performed for up to 12 months of follow-up, however, the risk of ERM recurrence remains. Using the technique of «release notches» allows to achieve higher functional results, compared with the group with ILM peeling and reduces the risk of relapse. Key words: vitrectomy; epiretinal fibrosis; peeling