The analysis of the results of surgical treatment of macular holes of varying degrees of complexity

2021 ◽  
pp. 117-121
Author(s):  
Y.I. Malakhova ◽  
◽  
E.M. Molokotin ◽  
◽  
◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Key Words ◽  
Macular Hole ◽  
Eye Diseases ◽  
Functional Parameters ◽  
Silicon Oil ◽  
Ocular Pathology ◽  
Macular Holes ◽  
Key Words Macular Hole

Purpose. To provide an analysis of the results of surgical treatment of macular holes, reflecting our own experience of vitreoretinal operations for this pathology of the macular interface. Material and methods. The work was carried out in a private ophthalmological clinic "EyeDoctor" in Almaty, Kazakhstan. The patients were divided into 3 groups, depending on the stage of macular holes and concomitant eye diseases. Results. 1. The macular hole 2-3 stage it is enough to carry out vitrectomy with careful removal of the ILM and PRP technology (the defect is up to 400 microns). 2. The macular hole 4 stage – removal the ILM with PRP technology with obligatory tamponade with silicon oil. Conclusion. To predict the results, it is necessary to take into account the stage of macular hole, its morphological and functional parameters, the duration of the process and the presence of concomitant ocular pathology. Key words: macular hole, J.D. Gass classification, vitrectomy, PRP method.

Platelet-rich plasma in surgery of various diameters idiopathic macular holes

2021 ◽  
pp. 51-53
Author(s):  
R.Z. Shamratov ◽  
◽  
L.S. Ramazanova ◽  
O.A. Napylova ◽  
◽  
...  
Keyword(s):  
Visual Acuity ◽  
Surgical Treatment ◽  
Macular Hole ◽  
Platelet Rich Plasma ◽  
Internal Limiting Membrane ◽  
Treatment Method ◽  
Macular Holes ◽  
Key Words Macular Hole ◽  
Promising Treatment ◽  
Idiopathic Macular Holes

The tactics of surgical treatment of the macular hole can be different and depends on the stage and diameter of the disease. Purpose. To study the results of surgical treatment of idiopathic macular detachments of various diameters with the use of autoplasma enriched with platelets. Material and methods. We observed 15 patients (15 eyes). Internal limiting membrane was peeled after vitrectomy. Platelet-rich autoplasmа was injected intravitreally. The observation period was 1 month. Results. As a result of surgical treatment, we were able to close the opening in all cases, restore the anatomy of the fovea and improve visual acuity in all patients. Conclusion. According to the assessment of the results obtained in the ongoing study, the use of this technology is an effective and promising treatment method based on the stimulation of the tissues' own regenerative potential. Key words: macular hole, surgical treatment, vitrectomy, platelet-rich plasma, visual acuity.

Morphofunctional analysis of the retina in the surgical treatment of idiopathic macular holes

2021 ◽  
pp. 48-52
Author(s):  
A.S. Zotov ◽  
◽  
A.S. Balalin ◽  
S.V. Balalin ◽  
S.M. Purshak ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Surgical Treatment ◽  
Macular Hole ◽  
Practical Importance ◽  
Functional Results ◽  
Hole Diameter ◽  
Optical Coherence ◽  
Macular Holes ◽  
Idiopathic Macular Holes ◽  
Morphofunctional Analysis

Purpose. To evaluate the role of microperimetry and optical coherence tomography (OCT) in the morphofunctional analysis of the retina after surgical treatment of idiopathic macular holes (IMH). Materials and methods. A retrospective study of 33 patient's treatment results (33 eyes) with IMH was carried out. All patients underwent minimally invasive with 25G or 27G vitrectomy. Best corrected visual acuity (BCVA), macular photosensitivity, fixation stability, macular neuroepithelial (NE) volume and minimal macular hole diameter were analyzed. Follow-up period: 6 months. Results. A complete closure of the macular hole was achieved in all cases post-op. The patients had reliable improvement of BCVA, retinal photosensitivity and decrease of macular NE volume. Based on a multifactor correlation analysis with the purpose to predict the results of surgical treatment, the dependence of post-op BCVA on the pre-op photosensitivity of the retina and the minimal diameter of the macular hole was revealed. Conclusions. Microperimetry and OCT are modern non-invasive research methods allowing to estimate anatomical and functional results of surgical IMH treatment. The study of retinal photosensitivity in the macula and minimal macular hole diameter pre-op allows to predict post-op BCVA, which has a practical importance. Keywords: idiopathic macular hole, vitrectomy, microperimetry, optical coherence tomography.

scholarly journals Surgical Treatment of Previously Unclosed Macular Holes

2020 ◽  
Vol 17 (3) ◽  
pp. 368-374
Author(s):  
R. R. Faizrakhmanov ◽  
E. A. Larina ◽  
O. A. Pavlovskii
Keyword(s):  
Visual Acuity ◽  
Surgical Treatment ◽  
Macular Hole ◽  
Free Flap ◽  
Inverse Correlation ◽  
Functional Results ◽  
Internal Limiting Membrane ◽  
Morphological Parameters ◽  
Photoreceptor Layer ◽  
Macular Holes

Macular holes are the most often pathology leading to reduced vision among persons after 60 years. The macular hole is the acquired disease which is a defect of a foveola part of retina on all thickness from an internal limiting membrane to an external segment of a photoreceptor layer. The standard method of treatment is surgery method: a microinvasive vitrectomy with membrane peeling in macular area. There is a number of the techniques increasing efficiency of operative intervention. Even in case of successful surgical intervention macular holes are not always closed.The purpose: development and assessment of morphological parameters of the central retina with a new surgical method of closing earlier operated macula hole using a free flap.Material and methods. 40 patients (40 eyes, 28 women and 12 men) had participated in this study. All patients were operated about macular hole with negative anatomic result. By technology which were used earlier, patients were divided into 3 studied groups (with PRP mass using, with introverted flap using, with mechanical matching of edges of a hole). The main method of research was the optical coherent tomography. All patients were operated by an original technique. It’s purpose was a closing of earlier operated rigid macular hole using a free flap.Results. The defect of a photoreceptor component was closed with an additional expansion of earlier created macular rexis in patients of the 1st and 3rd groups at reoperation. The earlier created flap of an internal limiting membrane was used in patients of the 2nd group. In the analysis of dependence of change of visual acuity from morphological parameters of a macular hole after primary surgical treatment the inverse correlation relation from diameter of a macular hole on small and big radiuses is revealed. The highest visual acuity after a reoperation was reached at patients of the second group.Conclusions. It is necessary to consider the technique which was used earlier, diameter of a macular hole on small and big radiuses, postoperative edema in a parafovea zone for planning the surgical treatment and a forecast of functional results. 

scholarly journals The influence of macular hole surgical treatment on biochemical tear fluid and blood serum indices

2013 ◽  
Vol 6 (4) ◽  
pp. 28-33
Author(s):  
Aleksey Vladislavovich Malyshev ◽  
Z Zh Al-Rashid
Keyword(s):  
Free Radical ◽  
Surgical Treatment ◽  
Blood Serum ◽  
Macular Hole ◽  
Visual Function ◽  
Biochemical Parameters ◽  
Free Radical Oxidation ◽  
Radical Oxidation ◽  
Macular Holes ◽  
Cataract Development

The present paper describes the changes of free radical oxidation (FRO) in patients with macular holes (MH) during vitrectomy. Material and methods. We examined 56 patients who underwent surgical treatment of MH. Results. We observed positive dynamics of FRO indices after surgery - a recovery of biochemical parameters in the late postop period. Among complications, a cataract development in patients who did not receive antioxidant therapy was observed. Conclusions. Vitrectomy improves visual function and FRO processes.

Comparative analysis of optical coherence tomography data in recurrent macular rupture after using various techniques for its blocking

2021 ◽  
pp. 109-112
Author(s):  
E.A. Larina ◽  
◽  
R.R. Fayzrakhmanov ◽  
O.A. Pavlovskii ◽  
◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Surgical Treatment ◽  
Surgical Intervention ◽  
Mechanical Action ◽  
Small Radius ◽  
Optical Coherence ◽  
Functional Parameters ◽  
Primary Surgery ◽  
Key Words Macular Hole ◽  
Tomography Data

Purpose. To assess the morphological parameters of the central retina in different groups with unblocked macular rupture after primary surgery for macular rupture (MR). Material and methods. This study involved 32 patients (35 eyes), including 19 women, 13 men. 3 groups were formed according to the principle of primary surgery. All patients underwent standard ophthalmological examinations, as well as optical coherence tomography (OCT). Results. According to OCT data, the morphological and functional parameters were different depending on the primary method of surgical treatment. The diameter of the MR along the large and small radius is the biggest in the 3rd group. The area of edema in the analysis of various methods of surgical treatment did not differ statistically. Conclusion. The functional parameters of the central part of the retina do not depend on the initial method of surgical intervention. The use of mechanical action on the retina causes rigidity of the edges of the macular rupture, and when using an introverted flap, the small and large diameters of the macular rupture remain minimal, in contrast to the use of platelet mass and mechanical closure of the MR. Key words: macular hole, platelet rich mass, introverted flap, mechanical closure, rigid.

Variants of the reparative activity of the foveolar zone in the closure of the macular hole by autoplasty in internal limiting membrane

2021 ◽  
pp. 126-131
Author(s):  
M.M. Shishkin ◽  
◽  
O.А. Pavlovskiy ◽  
E.A. Larina ◽  
◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Macular Hole ◽  
Morphological Changes ◽  
Central Zone ◽  
Internal Limiting Membrane ◽  
Original Method ◽  
Internal Boundary ◽  
Ophthalmological Examination ◽  
Functional Parameters ◽  
Group 2

Purpose. Propose a new technique of operation macular discontinuity, which is based on the preservation of the internal limiting membrane (ILM), and to assess the dynamics of retinal morphological and functional parameters for different embodiments of wound healing. Material and methods. The results of surgical treatment of 240 patients (240 eyes) with the diagnosis of macular hole were analyzed. Group 1 (120 eyes) – patients who underwent surgical treatment according to the standard method. Group 2 (120 eyes) – patients who were operated on using the original method with partial exfoliation of ILM in the Central zone. All patients underwent ophthalmological examination before and after surgery, including visometry, biomicroscopy, ophthalmoscopy and OCT. Results. Preoperative functional parameters of the retina in patients of both groups were comparable. During the study, two types of closure of macular tears were identified. When studying the morphological changes in the «pseudocyst» type of macular rupture repair in patients of both groups, a more pronounced resistance of the neuroretinal tissue is observed in patients of the 1st group. In the 2nd group, a more pronounced dynamics of a decrease in the morphological parameters of the hyporeflexive defect was revealed throughout the entire observation period. With the complete closure of the macular gap, a higher rate of regression of edema of neuroepithelial tissue is observed in patients of the 2nd group. Conclusion. Based on this study, we can conclude that during this technique, the ILM is preserved, which reduces the risk of intraoperative damage to the retinal layers. Key words: macular rupture, peeling, internal boundary membrane, optical coherence tomography.

The use of autologous conditioned plasma (ACP) in the surgical treatment of full-thikness macular holes

2021 ◽  
pp. 102-105
Author(s):  
I.V. Laskova ◽  
◽  
A.A. Kravchenko ◽  
D.I. Uskov ◽  
E.V. Lopina ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Macular Hole ◽  
High Efficiency ◽  
Silicone Oil ◽  
Pigment Epithelium ◽  
Subretinal Fluid ◽  
Ophthalmological Examination ◽  
Ophthalmic Surgery ◽  
Macular Holes ◽  
Number Of Patients

Increasingly, the use of autologous conditioned plasma in ophthalmic surgery in recent years has been given more preference than other blood products with similar effects. Surgical treatment of full-thikness macular hole is no exception. Domestic and foreign studies of recent years show that the use of ACP as an adhesive component in the treatment of this pathology is considered the most acceptable. However, in addition to the effective "gluing" of the macular hole, the convergence of its edges plays an important role in the postoperative anatomy of the foveolar zone. Objective: to study the effectiveness of the use of autologous conditioned plasma in the surgical treatment of full-thikness macular hole. Materials and methods of research. Patients who underwent surgery for a full-thikness macular hole with a diameter of more than 400 microns were prospectively observed. The study included 51 patients. The follow-up period ranged from 2 months to 1 year. All patients in the preoperative and postoperative periods underwent a comprehensive ophthalmological examination. Surgical technique: after a standard three-port vitrectomy (25Ga), the posterior hyaloid membrane was removed, and the ILM was peeled. With the help of a saline solution, a circular separation of the bonds between the edges of the gap and the pigment epithelium was achieved. After the subretinal fluid was removed and the induced local central retinal detachment was attached, the tear area was irrigated by ACP. After that, the air was replaced with silicone oil, which was removed after 1.5 months. Nodal sutures were applied to the sclerotomy (vicryl 8-0). Results. In 49 operated patients, anatomical restoration of the foveolar zone was achieved, which accounted for 96% of the total number of patients. Visual functions were evaluated after 1.5 months (after removal of silicone oil). Corrected visual acuity in 96% of patients ranged from 0.2 to 0.5. Conclusion. The high efficiency of the use of autologous conditioned plasma in the treatment of full-thikness macular holes allows us to achieve high anatomical and functional results. Key words: macular rupture, autologous conditioned plasma, silicone tamponade.

scholarly journals Analysis of surgical treatment results of macular holes in the Samara region

2017 ◽  
Vol 98 (3) ◽  
pp. 397-400
Author(s):  
D V Petrachkov ◽  
A V Zolotarev ◽  
P A Zamytskiy ◽  
E V Karlova ◽  
I S Kazakov
Keyword(s):  
Surgical Treatment ◽  
Macular Hole ◽  
Medical Records ◽  
Functional Results ◽  
Internal Limiting Membrane ◽  
Aim Analysis ◽  
Corrected Visual Acuity ◽  
Macular Holes ◽  
Ophthalmic Hospital ◽  
Hole Closure

Aim. Analysis of anatomical and functional results of surgical treatment of full-thickness macular holes. Methods. We conducted a retrospective analysis of medical records of 194 outpatients (194 eyes) on whom surgical treatment of macular hole was performed in Samara Clinical Ophthalmic Hospital n.a. T.I. Eroshevskiy during 2015-2016. Results. On day 5 after surgery in 96 (97.9%) patients with a hole of more than 400 µm operated according to inverted flap technique, and in 93 (96.9%) patients with hole of less than 400 µm, on whom removal of the internal limiting membrane around the hole was performed, we observed macular hole closure. The best corrected visual acuity of patients with the hole of more than 400 µm increased to 0.18±0.13 (p

FEATURES OF OPHTHALMIC CARE FOR PATIENTS WITH COMPLICATED CATARACTS

2020 ◽  
pp. 84-89
Author(s):  
Inna Ivanovna Lapkina
Keyword(s):  
Health Care ◽  
Surgical Treatment ◽  
Postoperative Complications ◽  
Key Words ◽  
Outpatient Treatment ◽  
Practical Application ◽  
Unified Approach ◽  
Case Histories ◽  
High Prevalence

Today, around 50 million people worldwide suffer from cataracts, more than a half of them need surgical treatment. High prevalence of this pathology in Ukraine, the need to improve the provision of ophthalmic care to patients, and the reform of the health care system have made the research relevant. Concomitant diseases and special conditions of the eye increase the risk of intra− and postoperative complications, worsen the functional parameters of patients after surgery. In order to develop a unified approach to the treatment of complicated cataracts based on diagnostically related groups of patients, a retrospective analysis of case histories of patients with different variants of complications related to the condition of the lens itself, its ligament apparatus and other structures of the eye was conducted. In each case, the surgeon has to choose the appropriate modification of cataract phacoemulsification surgery. The study proposed the classification of cataract phacoemulsification modifications on the basis of the techniques and the sequence of operation stages, taking into account the classification of the degrees of turbidity of the lens, proposed by L. Buratto. It has been noted that in complicated cases, according to the indications of the patient, surgery may be performed on several modifications of cataract phacoemulsification. The developed classification made it possible to generalize the various variants of pathology and greatly facilitate the choice of tactics of surgical treatment in complicated cataracts. It can be used not only for practical application, but also for improving the qualification of trained professionals. The prospect of further research is to identify contraindications for outpatient treatment of the patients with complicated cataracts. Key words: cataract complication, classification of phacoemulsification modifications, diagnostically related groups.

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