METHOD OF SURGICAL TREATMENT OF MACULAR EDEMA, COMPLICATED BY EPIRETINAL MEMBRANE IN DIABETES MELLITUS

摘要

FIELD: medicine.;SUBSTANCE: invention relates to medicine, specifically to ophthalmology. For the surgical treatment of patients with macular edema complicated by the epiretinal membrane in diabetes mellitus, local posterior vitrectomy is performed with removal of the posterior hyaloid membrane, along with tamponade of the vitreal cavity with air and the introduction of an anti-vasoproliferative preparation. At the preoperative stage, microperimetry of the macular zone is conducted within radius of 12° from the point of fixation of the gaze. Surgical intervention is carried out using 27G technology, staining and removing the posterior hyaloid, epiretinal and internal limiting membrane (ILM) under intraoperative OCT control. ILM peeling is performed circularly, starting from the place with the lowest photosensitivity according to microperimetry, while performing ILM separation over 2–3 hour meridians with a movement directed along an arc of an imaginary circle centered in foveola, the ILM isolated along the arc is intercepted and further separation thereof with a circular motion is carried out. When an intraoperative OCT is detected in the projection of the fovea-hyporeflective formation with a diameter of more than 200 mcm, ILM peeling is completed at the site of the onset of the cyst.;EFFECT: method ensures the safe elimination of traction effects and contributes to the creation of favorable conditions for resorption of edema by the method of drug accumulation in the central zone of the retina.;1 cl, 2 ex