METHOD FOR LARGE IDIOPATHIC MAPULAR BREAKDOWNS SURGICAL TREATMENT USING "INTERNAL BORDER MEMBRANE REVERSED FLAP" TECHNIQUE Russian patent published in 2017 - IPC A61F9/07 

FIELD: medicine.

SUBSTANCE: vitrectomy is performed through three-port micro-accesses with isolation and excision of the posterior hyaloid membrane, staining of the internal border membrane, followed by partial makulorexis, starting from the temporal side. The stained IBM is separated and removed by sectors, moving along a circle in one and the other side, which resembles flower petals removal. One sector (one petal) of IBM is not removed from the nose, that is wider than the macular rupture diameter, and the "reversed flap" technique is applied thereto: the remaining flap is lifted by the micropsy cracks at the outer border edge and is cut off towards the center, stopping at the distance of 0.1-0.2 mm from the macular rupture edge, then the flap is reversed and placed on the macular rupture, closing the rupture, then the flap is gently pinched by the instrument, followed by vitreal cavity tamponade, according to the invention, a drop of the perfluororganic compound (PFOC) is applied to the macular rupture using the 27G cannula prior to IBM staining. Staining produce is not completed: a membrane sector, which is designed to close the macular rupture is left unstained, for this purpose IBM staining begins with the temporal side, successively moving in a circle in one and the other side to the borders of the planned flap, and after dye application and 30-60 seconds of exposure, the excess dye is removed via cannula with a silicon tip, moving in the opposite direction from the unstained area, excess dye near the flap is removed by passive aspiration, and further saline is supplied to the vitreal cavity under low pressure and the remaining dye is removed, then the PFOC drop is removed from the macular rupture, and partial makulorexis is performed, during which the IMB portions adjacent to the macular rupture edge are separated from the retina except for the flap area, after that, the unstained flap is removed towards the center, reversed and used to close the macular rupture. The flap is slightly pinched using a cannula with a silicone tip, and finally the vitrreal cavity is plastered with air, and then with a gas-air mixture.

EFFECT: method allows to obtain a higher functional result in the postoperative period.

4 cl, 1 ex