Mikrokirurško liječenje rupture žute pjege. (Croatian)

Microsurgical treatment of macular holes. (English)

A macular hole is a disorder of the most delicate structures in the central retina. Left untreated it usually leads to severe loss of visual acquity. Microsurgical treatment of macular holes is first mentioned in 1991 by Kelly and Wendell. It has been more than 20 years since those rather simple beginnings using classical vitrectomes with bigger radius and air tamponade to the suture-free microincision technologies we use today. Internal limiting membrane peeling in combination with special vital dyes and new types of tamponade upgraded the anatomical and functional success of these surgeries. Usage of optic coherence tomography enables better analysis of vitreoretinal disorders and monitoring postoperative changes in the macular area. New methods in treatment of complicated macular holes such as inverted internal limiting membrane flap, pharmacologic vitreolysis, retinal transplantation and new options of conservative treatment in initial stages of macular holes give confidence that there is still room for improvement in treatment of macular holes. [ABSTRACT FROM AUTHOR]

Ruptura žute pjege poremećaj je koji zahvaća najdelikatnije strukture centralne mrežnice. Neliječena uglavnom dovodi do značajnog gubitka centralne vidne oštrine. Mikrokirurško liječenje rupture žute pjege prvi put se spominje 1991. godine u radovima Kelly i Wendela. Od tih relativno jednostavnih početaka uz upotrebu klasičnih vitrektoma velikog promjera i upotrebe zraka kao tamponade na kraju operacije do razvoja bešavnih mikroincizijskih tehnologija prošlo je više od 20 godina. Uvođenjem ljuštenja membrane limitans interne uz pomoć posebnih vitalnih boja i novih vrsta tamponada poboljšao se anatomski i funkcionalni uspjeh ovih operacija. Upotrebom optičke koherentne tomografije omogućena je bolja analiza vitreoretinalnih promjena, kao i praćenje postoperativnih promjena u području žute pjege. Nove metode u liječenju kompliciranih ruptura žute pjege kao što su formiranje inverznog poklopca od tkiva membrane limitans interne, farmakološka vitreoliza, transplantacija retine te novi oblici konzervativnog liječenja kod početnih ruptura žute pjege daju nadu da sve mogućnosti liječenja ove bolesti nisu iscrpljene. [ABSTRACT FROM AUTHOR]

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