Differential approach to surgical treatment of cicatricial stage of subretinal neovascular membrane

    Abstract

    Differential approach to surgical treatment of cicatricial stage of subretinal neovascular membrane

    Arsiutov D.G., Andreev A.N.

    Medical Institution «Republican Clinical Ophthalmological Hospital» Chuvash Ministry of Health, Cheboksary;
State Budgetary Education Institution of Higher Professional Education «Chuvash State University named after I.N. Ulyanov», Cheboksary

    

    In the period from 2010 till 2015 the analysis of effectiveness of transretinal removal of subretinal neovascular membrane in cicatricial stage and subretinal lucentis introduction to 17 patients was made.

    Material and methods. We worked out the stages of surgical treatment of patients with the given pathology: subtotal vitrectomy with posterior hyaloid membrane removal, transretinal removal of cicatricial tissue through microretinotomy, subretinal lucentis (0,01-0,02 ml) introduction, short-term PFCs tamponade (according to prescriptions), endolaser coagulation around microretinotomy (according to prescriptions), pneumoretinopexy.

    Results. The reduction of metamorphopsias, «black spot» in front of the eye in various degrees, insignificant rise of image contrast were observed in 65% postoperative patients. Visual acuity improvement up to 0,01-0,09 on average, was observed in 75% of patients. According to postoperative OCT data: pigment epitelium in the most of cases is partially preserved.

    Conclusion. Microinvasive transretinal removal of subretinal neovascular membrane on a cicatricial stage, in combination with subretinal lucentis introduction and differential approach to the selection of patients leads to the improvement of anatomical and functional condition of central parts of the retina and reduces the risk of recurrent neovascularization.

    Key words: subretinal neovascular membrane, cicatricial stage, lucentis.