Chirurgie des großen und persistierenden Makulaforamens

Haritoglou, Christos; Wolf, Armin und Wachtlin, Joachim (2019): Chirurgie des großen und persistierenden Makulaforamens. In: Ophthalmologe, Bd. 116, Nr. 11: S. 1011-1019

Abstract

Modern macular hole surgery results in high closure rates of over 90% and good functional results especially in macular holes up to 400 & x202f;mu m in diameter. The standard of care in most of these cases consists of transconjunctival sutureless pars plana vitrectomy, peeling of the inner limiting membrane (ILM) around the hole, followed by gas tamponade and positioning of the patient. As closure rates and functional results decrease with larger macular hole diameters over approximately 400 & x202f;mu m, alternative surgical techniques have been introduced to improve anatomical and functional results in these cases. These techniques include the positioning of tissue within the macular hole to improve hole closure. This can be performed using an ILM flap or free flap technique and the transplantation of autologous retinal tissue, lens capsule or homologous amniotic tissue in or under the defect. An alternative promising approach is the attenuation of the rim of the hole by induction of a localized retinal detachment at the posterior pole which is achieved by subretinal injection of balanced salt solution (BSS) using a 41 gauge needle. The operation is completed by an endotamponade using gas or silicone oil.

• Dokumententyp: Zeitschriftenartikel
• Fakultät: Medizin
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• ISSN: 0941-293X
• Sprache: Deutsch