METHOD OF SURGICAL SERVICE OF THE IDIOPATHIC EPIRETHINAL MEMBRANE Russian patent published in 2018 - IPC A61F9/00 A61F9/07 

FIELD: medicine.

SUBSTANCE: invention refers to medicine, specifically to ophthalmology. For the surgical service of idiopathic epiretinal membranes (iEPM), Triamcinolone acetonide is inserted to the vitreal atrium before excision of the vitreous body and chromovirrectomy is performed. Further, coloring material membrane blue 0.15 % is brought to the macular zone. Exposure dose for 15 seconds is hold and it aspiration of cannulas is made. After that they begin to remove iEPM with the help of "petalled" technique, for this, the edge of the first grap of the iERM is formed with endovitreal approximating forceps using a pinch in the place of the least fixation and guide this grap along an arc of an imaginary circle, separating the iEPM towards the center of the fovea, while controlling that the fixing zone of the iEPM to the fovea be intact. Then they proceed to the formation of the second grap of the iEPM next to the first one and, by the same technique, carry out its excision, executing the direction of movement to the fovea, where they leave the iEPM untouched. If a zone of significant anchorage iEPM to the retina is detected, membrane grap from the retina is cut by the vitreotus cutter in a circle, leaving the tissue fusion tela intact, remnants of the iEPM separate to the fovea with approximating forceps. Similarly, each subsequent grap is formed in a clockwise direction and 7–10 graps of iEPM in the fovea zone are collected. Further, the excision of iEPM is performed for the lower grap, passing it through the fovea upwards, after this, the second contrast study of the macular zone is carried out with the same coloring material for 15 seconds, ablate it with suction cannula. In case of detection of the next layer of iEPM its excision is performed according to the technique described above, after that the third contrast study of the macular zone is carried out with the same coloring material after its exposure in 15 seconds, its cannula is aspirated, Also, the excision of external limiting membrane (ELM) is also carried out according to the above-described "petalled" technique. At the final stage, swabbing of the vitreal absconsio is carried out with air and the portals are ablated.

EFFECT: method allows to negate retina’s tractions, reduce the traumatic nature of surgical intervention, improve visual acuity and improve the quality of patients' vision.

1 cl, 2 ex