Náš pohled na léčbu idiopatické makulární díry
| Title in English | Our view on the treatment of idiopathic macular holes |
|---|---|
| Authors | |
| Year of publication | 2009 |
| Type | Article in Proceedings |
| Conference | Sborník abstrakt XVII. výročního sjezdu České oftalmologické společnosti |
| MU Faculty or unit | |
| Citation | |
| Field | ORL, ophthalmology, stomatology |
| Keywords | idiopathic macular hole; trypane blue; pars plana vitrectomy; gas tamponade; peeling of the internal limiting membrane; prone positioning of the head |
| Description | The aim of our communication is to present our methodology we use in the treatment of idiopathic macular holes and which seems optimal in terms of achievements. We provide standard 3port PPV, which includes complete removal of vitreous, posterior hyaloide membrane elevation and its removal to the periphery. PPV is a combined with lenses operation, if present, some degree of cataract. Internal limiting membrane (ILM) is removed using a blue dye (Membrane blue, DORC). At the end of the operation is performed exchange water for gas mixture of 15% C3F8 (perflouropropanu). Patients are instructed to follow a period of 1 week facedown positioning. High rate of success of the operation depends on the size of pressure, which creates an expansive bubble of gas in the macular area. This value is influenced by two variables. The first is the size of the bubble and the second is the patient's cooperation for the purposes of compliance with the instructions on the need for postoperative facedown positioning. The size of bubbles can affect the use of gas, which has greater expansion capacity. In our case, we use predilectly the C3F8 instead SF6. The second variable (postoperative positioning) is very difficult influenced, especially in the emerging era of outpatient vitreoretinal surgery. PPV supplemented by internal limiting membrane peeling and gas tamponade is an expansive safe method for the treatment of idiopathic macular holes. If is diagnosed before surgery cataract, we combined PPV with cataract surgery. |