METHOD FOR SURGICAL MANAGEMENT OF IDIOPATHIC MACULAR THROUGH HOLE

摘要

FIELD: medicine.;SUBSTANCE: internal limiting membrane (ILM) tip is separated from a retina at 2.0-2.5 mm to an inferior temporal arch from a foveola; with the ILM tip taken by forceps, the membrane is separated throughout 2-3 o'clock meridians by performing a motion directed through an arc of a virtual circle with the macular rupture in the middle with controlling the retinal segment found at 1.0-1.2 mm from the rupture border remained intact. The ILM separated through an arc is embraced in its final point and separated stopping 0.5-0.8 mm short of the rupture border by performing a radial motion. The ILM is embraced again in its final point and separated throughout 2-3 o'clock meridians in the reverse direction. The procedure is controlled to be sure that the retinal segment found at 0.5-0.8 mm from the rupture border is intact. The separation of the given ILM segment is completed by performing a radial motion thuswise leading to the initial point. The procedure described above is supposed to be applicable for successive exfoliation of the ILM segments. A foveolar ILM fragment surrounded by an ILM-free open-ring retinal area is formed around the macular rupture; the last ILM segment is removed so as to preserve a small intersection and to prevent the ring from closing; the preserved intersection is separated to the centre stopping 0.5-0.8 mm short of the rupture border, and the ILM intersection is separated from the retina. Sectors throughout 2-3 o'clock meridians are separated from the retina in the formed foveolar ILM fragment from two opposite sides from the periphery to the centre stopping approximately 50 mcm short of the macular rupture border; thereafter, a vitreous cutter is used to remove the ILM tissue within the separated segments thereby forming two opposite hollows in the foveolar ILM fragment. The segments of the remained portion of the foveolar ILM fragment are separated from the retina with preserving adhesion along the macular rupture border. The segments of the foveolar ILM fragment are turned over and placed on one another thereby closing the macular rupture; the segments placed into the macular rupture are slightly pressed down from above.;EFFECT: invention provides removing the vertical and horizontal retinal tractions, closing the macular tractions completely, improving the visual functions.