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Малафеев А.В.
Poylova Е.S., Malafeev А.V., Stoyanov Y.N.
EXPERIENCE OF SURGICAL TREATMENT OF LARGE AGE-RELATED MACULAR HOLES WITH DIAMETERS GREATER THAN 1000 MICRONS
Purpose — 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 5th 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.
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Editor-in-chief |
Sergey Aleksandrovich
MIROSHNIKOV |
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