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Repeated surgical closure of the macular tears using the “free flap” technique of the internal border membrane


The lack of a single surgical approach with repeated closure of the macular tears makes it relevant to make further research in this direction. The goal is to develop the technology of repeated surgical closure of macular tears with the use of the method “free flap” of Internal border membrane. Material and methods: the study included 9 patients (9 eyes) in age from 56 to 71 years with idiopathic macular tears (IMT), not closed after primary surgery. Previously all patients underwent surgery: vitrectomy with removal of ILM with the convergence of the edges of the gaps with the help of vacuum suction and tamponade of vitreous cavity gas-air mixture. In all the above cases, the closure of the IMT has not happened. All patients were operated on with application of the developed technique of the “free flap” of VPM. Results : according spectral optical coherence tomography, 1 month after the closure of the IMR was observed in 8 cases (88.9 %). However, 3 patients experienced closure of IMR-type “scar”, from 5 - closure with “defect” at the level of the ellipsoid zone of the photoreceptors. After 3 months in 3 patients there was recorded a decrease of the diameter of the “defect” of the ellipsoid zone of photoreceptors. In 5 of 9 cases on the surface of the retina in the region of the fovea was determined for a fragment of VPM. Conclusion: the technology of repeated surgical closure of macular tears with the use of the method “free flap” VPM is safe and effective in the surgical treatment is not closed after the initial surgery Mr.


macular tears; “free flap” technique; internal border membrane

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Medicine. modern achievements in ophthalmology

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