METHOD FOR SURGICAL MANAGEMENT OF THROUGH IDIOPATHIC MACULAR RUPTURE

摘要

FIELD: medicine.;SUBSTANCE: end of an internal limiting membrane (ILM) is separated from a retina at 2.0-2.5 mm to an inferior temporal arcade from a rupture edge. A pair of pincers is used to grip an ILM end; the membrane is separated throughout 2-3 o'clock meridians by doing a motion directed along a segment of an imaginary circle with the macular rupture in the centre. A retinal section is controlled to be intact at 1.0-1.2 mm from the rupture edge. The following stage involves embracing the separated ILM in an end point and moving along the circle radius to separate the ILM stopping 0.5-0.8 mm short of the rupture edge. The ILM is embraced again in the end point and separated throughout 2-3 o'clock meridians in the opposite direction. The ILM separation is completed by performing a radially directed motion arriving in the initial point. The described manipulations are repeated to form a foveolar fragment of the ILM. The last ILM segment is removed so as to prevent the ring from closing at 2.5-3.0 diameters of the macular rupture. The ILM flap is separated in the direction from an outer border to the centre stopping 0.5-0.8 mm short of the rupture edge. The flap is turned over and placed on the macular rupture.;EFFECT: reducing the number of injuries accompanying the surgical intervention, eliminating the vertical and horizontal retinal tractions, closing the macular rupture completely, improving the visual functions.