2015, № 12 (187)

Poylova Е.S., Malafeev А.V., Stoyanov Y.N. EXPERIENCE OF SURGICAL TREATMENT OF LARGE AGE-RELATED MACULAR HOLES WITH DIAMETERS GREATER THAN 1000 MICRONSPurpose — to analyze the efficiency of surgical treatment of large idiopathic macular holes using short-term tamponade with perfluordecalin (PFOC) and its subsequent removal. Materials and methods. Analyzed the results of 30 patients (30 eyes) treatment operated for this disease in 2013–2014. Average corrected visual acuity before surgery was 0.1. All patients underwent vitrectomy micro-invasive technology 25–27 G to remove the back hyaloid membrane, membranorexis internal limiting membrane, short-term tamponade and vitreous cavity PFOC followed by comparing the edges of the hole. Results of surgical treatment were estimated using spectral optical coherence tomography on the 5^th day, 1.5 months, 6 months and 1 year. The results and discussion. Full closure of the holes was observed in 26 eyes (87 %). During the two-year follow-up period of relapse was noted. In all cases for imaging results observed profile of the fovea was formed, the layers of the retina compared anatomically, the photoreceptor layer was rarefied. The increase in visual acuity after treatment, though statistically significant, is not always consistent with the expected results on the part of the patient. The proposed method of surgical treatment of macular holes with diameters greater than 1 000 microns is effective. The technique allows to eliminate subjective discomfort that occurs when tamponade with silicone oil or gas-air mixture. However, after the closing of the hole it is not always functional recovery, as reparative processes, probably, safety outer limiting membrane plays a role.Key words: large idiopathic macular hole with diameters greater than 1 000 microns, vitrectomy 25–27 G, PFOC tamponade.

Download

References:

1. Alpatov S.A., Shuko A.G., Malyshev V.V. Pathogenesis and Treatment of idiopathic macular ruptures. — Nauka, Novosibirsk, 2005. — p.192

2. Alpatov S.A. Surgical treatment of macular holes through large diameter // Ophthalmosurgery . — 2005. — № 1. — pp. 8-12.

3. Takhchidi K.P., Shkvorchenko D.O., Sharafetdinov I. H. Features surgery macular breaks // All Russian Seminar — "panel discussion" "Macula -2006", 2nd: Thes. rep. — Rostov-on-Don, 2006. — p. 177.

4. Shpak A.A., Shkvorchenko D.O., Sharafetdinov I.H., Ogorodnikov S.N., Yukhanova O.A. Changes related macular area after endovitreous interventions for idiopathic macular rupture // Ophthalmosurgery. — 2013. — № 4. — pp. 78-81.

5. Shpak A.A., Shkvorchenko D.O., Sharafetdinov I.H., Yukhanova O.A. Prediction anatomical effect of surgical treatment of idiopathic macular rupture // Modern technologies in ophthalmology. — 2015. — № 1. — pp. 136-138.

6. Brooks H.L., Macular hole surgery with and without internal limiting membrane peeling // Ophthalmology. − 2000. − Vol. 107. − P. 1939-1949.

7. Itoh Y., Inoue M., Tosho R. et al. Correlation between length of foveal cone outer segment tips line defect and visual acuity after macular hole closure // Ophthalmology. − 2012. − Vol. 119. − 1438-1446.

8. Itoh Y., Inoue M., Tosho R. et al. Significant correlation between visual acuity and recovery of foveal cone microstructures after macular hole surgery // Am. J. Ophthalmol.− 2012.− Vol. 153, № 1− P. 111-119.

9. Michael S., Baker Brad J., Duker Jay S., et al. Anatomical Outcomes of Surgery for Idiopathic Macular Hole as Determined by Optical Coherence Tomography // Arch. Ophthalmol. — 2002. − № 1. − P. 29-35.

10. Salter A.B., Folgar F.A., Weissbrot J., Wald K.J. Macular hole surgery prognostic success rates based on macular hole size // Ophthalmic Surg. Lasers Imaging. — 2012. — Vol. 43, № . — N.3. — P. 184-189.

11. Sevim M.S., Sanisoglu H. Analysis of retinal ganglion cell complex thickness after Brilliant Blue-assisted vitrectomy for idiopathic macular holes // Curr. Eye Res. − 2013. — Vol. 38. — P. 180-184.

12. Shimozono M., Oishi A., Hata M., et al. Restoration of the photoreceptor outer segment and visual outcomes after macular hole closure: spectral-domain optical coherence tomographic analysis // Graefes Arch. Clin. Exp. Ophthalmol. − 2011. − Vol. 249. − P. 1469-1476.

13. Takayuki B., Yamamoto S., Arai M., et al. Correlation of visual recovery and presence of photoreceptor inner/outer segment junction in optical coherence images after successful macular hole repair // Retina. — 2013. − Vol. 32, № 3. — P. 453-458.

14. Yanagy Y., Jang W.D., Kadonosono K. Evaluation of the safety of xenon/bandpass light in vitrectomy using the A2E-laden RPE model // Graefes Arch. Clin. Exp. Ophthalmol. — 2007. — Vol. 245. — P. 677-681.

15. Wakabayashi T., Fujiwara M, Sakaguchi H. et al. Foveal micrustructure and visual acuity in surgically closed macular holes: spectral-domain optical coherence tomographic analysis // Ophthalmology. − 2010. − Vol. 117. − P. 1815-1824.

About this article

Authors: Malafeev A.V., Poylova E.S., Stoyanov Yu.N.

Year: 2015

Editor-in-chief

Sergey Aleksandrovich
MIROSHNIKOV

© Электронное периодическое издание: ВЕСТНИК ОГУ on-line (VESTNIK OSU on-line), ISSN on-line 1814-6465
Зарегистрировано в Федеральной службе по надзору в сфере связи, информационных технологий и массовых коммуникаций
Свидетельство о регистрации СМИ: Эл № ФС77-37678 от 29 сентября 2009 г.
Учредитель: Оренбургский государственный университет (ОГУ)
Главный редактор: С.А. Мирошников
Адрес редакции: 460018, г. Оренбург, проспект Победы, д. 13, к. 2335
Тел./факс: (3532)37-27-78 E-mail: vestnik@mail.osu.ru