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Y. V. Bayborodov, Jr., T. M. Dzhusoev, Jr.; Transvitreal Microinvasive Surgery of Vitreo-Macular Interface. Invest. Ophthalmol. Vis. Sci. 2008;49(13):4702.
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To develop surgical technique for removal of posterior hyaloid membrane (PHM) and inner limiting membrane (ILM) in patients with epiretinal fibrosis, using microinvasive approach to macular region without vitrectomy and with following repair of vitreous by hydrovitreopexy.
Twenty eyes of fourteen patients, 55-80 years of age, diagnosed with epiretinal macular fibrosis, underwent surgical removal of PHM and ILM without vitrectomy. Surgical procedure started with formation of two transconjunctival 25-guage ports: one for light pipe, another for forceps to peel ILM. Dyeing of ILM was not used. Forceps were moved transvitreally towards macula to capture ILM and immediately conduct it out of the eye. Then, surgical ports were hermetically closed and 30-guage needle was used to inject saline into the center of vitreous cavity until normal tension was reached. Patients were followed for six months.
Visual acuity (VA) improved after surgery beginning on the first post-operative day in all patients. Table shows mean (Standard Deviation) values for VA and retinal thickness before and at different time points after surgery.No intra- or post-operative complications were observed during the follow-up period.
Transvitreal microinvasive procedure without vitrectomy does not result into proliferation of the vitreous. We believe, our method is highly effective and safe for surgical treatment of patients with epiretinal fibrosis.
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