METHOD FOR SURGICAL TREATMENT OF SECONDARY MACULAR RETINAL BREAKS WITH EPIRETINAL PROLIFERATIVE STRUCTURES (OPTIONS) Russian patent published in 2022 - IPC A61F9/07 A61F9/08 

FIELD: medicine.

SUBSTANCE: inventions group relates to medicine, namely to ophthalmology. According to the first variant, transconjunctival subtotal three-port 27G vitrectomy is performed, epiretinal proliferative structures (EPS) and internal limiting membrane (ILM) are stained, and ILM peeling is performed. At the same time, peeling of the ILM is started from the side of the lower temporal vascular arcade, for which, in the place of clear staining, the ILM is torn at a distance of 2 mm from the edge of the gap, the ILM is separated from the retina and lifted as a single block with EPS, not reaching the edge of the macular hole 0.5 mm. In the same way, the separation of the "ILM-EPS" complex is performed in all quadrants concentric to the macular hole (MH), with the exception of a retinal area 2 MH diameters wide from the side of the upper temporal vascular arcade at 12 o'clock, which is left intact. The separated complex "ILM-EPS" is removed with a vitreotomy so that the zone of the intact retina is preserved concentrically to the MH with a width of 0.5 mm and from the side of the superior temporal vascular arcade at 12 o'clock with a width of 2 MH diameters. Then the intact area "ILM-EPS" at 12 o'clock with a width of 2 MH diameters is separated from the underlying retina in a single block in the direction of the MH center, not reaching the edge of the macular hole 0.5 mm, it is turned over and the side of the epiretinal membrane (ERM) is placed on the macular hole . According to the second option, if it is impossible to visualize the ILM due to a continuous layer of the EPS and to determine the boundary between the EPS and the ILM, the ERM is separated from the side of the inferior temporal vascular arcade towards the center of the macular hole, not reaching its edge by 0.5 mm and not crossing the horizontal line, passing tangentially to the lower edge of the ONH. Then the EPS is cut off with a vireotome; perform re-staining of the EPS of the macular zone of the retina. After that, the EPS freed from EPS is removed in local areas, not reaching the edge of MH 0.5 mm. The rest of the EPS of the macular zone is concentric to the MH, with the exception of a retinal area 2 MH diameters wide from the side of the upper temporal vascular arcade at 12 o'clock, which is left intact, is removed as a single block with the ILM. Then, the intact area of ​​"ILM-EPS" at 12 o'clock, 2 MH diameters wide, is separated from the underlying retina as a single block in the direction of the MH center, not reaching the edge of the macular hole 0.5 mm, it is turned over and the ERM side is placed on the macular hole.

EFFECT: inventions group provides reduction of surgical intervention trauma, no need to use PFOS, permanent closure of the macular hole, restoration of the normal structure of the retina, high postoperative visual functions, no recurrence of the disease and no need for repeated treatment.

2 cl, 2 ex