Authors
Fajzrahmanov R.R., Pavlovskij O.A., Larina E.A.
Pirogov National Medical and Surgical Center, Ophthalmology Clinic, Moscow
Abstract
Today the only way to treat patients with macular rupture is to perform vitrectomy with peeling of the internal limiting membrane. There is more and more data on traumatic changes in the layer of nerve fibers of the retina (damage of Muller cells) during surgery with macular rupture, namely when pilling the inner border membrane. The aim of the study was to develop a new pilling technique, which is based on the partial preservation of the inner border membrane and the assessment of the dynamics of the anatomical and functional parameters after the operation. The results of surgical treatment of 56 patients were analyzed. All patients underwent surgery within a month, depending on the tactics of the treatment all patients were divided into two groups: group 1 (surgical treatment according to the standard method), group 2 (preservation of the inner border membrane on the nasal side). Various parameters of macular rupture were evaluated by analyzing images of optical coherence tomography. In patients of the 1st group, macular rupture closure was observed in 23 cases. In patients of the 2nd group — in 24 cases. A gradual increase in functional results in the postoperative period was revealed using the proposed technique, which was expressed in an increase in visus acuity in the 7th to 30th day by 1.41 times; we can also note the regression of edema of the foveol zone in patients of the 1st and 2nd groups. Thus, the proposed technique is less traumatic compared to the classical one. The most physiological parameters of the foveolar zone in the postoperative period were obtained, there is no retinal thinning, more rapid regression of edema in the altered neuroepithelial part of the retina is noted.
Keywords: macular rupture, vitreoretinal surgery, internal limiting membrane, Mueller cells.
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