METHOD FOR SURGICAL TREATMENT OF IDIOPATHIC MACULAR LESIONS Russian patent published in 2019 - IPC A61F9/07 

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to ophthalmosurgery. In the surgical management of idiopathic macular ruptures of the retina, vitrectomy is performed through three-port microdevices with extraction and excision of the posterior hyaloid membrane, staining of the internal border membrane (IBM) of the retina with subsequent removal thereof, wherein the membrane region adjacent to the edge of the macular rupture in the form of a ring remains intact, then the final tamponade of the vitreal cavity is performed, and the macular rupture is blocked. Vitrectomy is performed through the ports equipped with the valve system, and before the IBM painting on the macular break using the cannula the drop of perfluororganic compound (PFOC) with the diameter equal to 1.5–2.0 of the macular fracture diameter is applied, after which, during dyeing time, supply of balanced salt solution (BSS) to vitreal cavity is disconnected. Membrane is coloured, waited for 30 seconds and the paint is aspirated using an extrusion cannula. Then, the PFOC drop is removed, and the IBM is removed, and the retinal segment is visually monitored to be intact at distance of 0.7–1.0 mm from the edge of the macular rupture. Further, additional delicate separation is performed in a circle, reducing the distance of the intact segment from the rupture edge to 0.1–0.2 mm with strong adhesion of the membrane and underlying retinal layers and to 0.3–0.4 mm with weak adhesion, after that, the vitreotype is brought in, and the separated membrane in the form of a bowl is cut off, moving from the upper sections to the bowl base, not reaching base 0.2–0.3 mm. After removal of the IBM, the vitreal cavity is plated by replacing the BSS solution with air, then using a cannula installed above the rupture, macular ruptures are brought by passive aspiration, followed by macular rupture of the autologous thrombocyte enriched plasma. In case of failure of fracture edges by passive aspiration due to traction radial dissection of intact ring is performed and repeated closure is performed. During operation of the vitreous cutter, a mode – cut frequency of not less than 5,000 cuts per minute is used; vacuum force 50 mm Hg.

EFFECT: method reduces surgical injuries, reduces operation time at the stage of IBM removal, increases the guarantee of complete closure of macular retinal rupture and visual acuity after operation.

3 cl, 2 ex