Od júna 1992 do novembra 1997 sme na I. očnej klinike FN a LF UK v Bratislave odstránili subretinálnu neovaskulárnu membránu (SNM) u 15 pacientov vo veku do 57 - 72 rokov. U 13 bola membrána spôsobená vekom podmienenou degenera¬ ciou ihakuly, u jednej pacientky pravdepodobne chorioiditídou neznámej etiológie a u jednej pacientky asi kombináciou vekom podmienených a myopických zmien. U troch pacientov bola prítomná len SNM, u ostatných aj subretinálne krvácania, odlúpenie sietnice alebo hemoftalmus. Predoperačná zraková ostrosť bola svetlocit -1/50. Po extrakcii membrány sa sietnica tampónovala na 10 očiach silikonovým olejom a na 4 očiach expanzným plynom. Jedna operácia sa pre veľmi intenzívne peroperačné krvácanie predčasne ukončila. Pacientov sledujeme 2 52 mesiacov. V tomto období sa u deviatich z nich uskutočnilo 12 dalších operácií. Tri oči majú výslednú zrakovú ostrosť 0, štyri oči pohyb ruky pred okom, 6 očí do 1/50 a dve oči do 5/50. Dve oči atrofujú. Na jednom oku je totálna amócia sietnice. Tri oči sú pre PVR vyplnené silikonovým olejom, dve z nich pravdepodobne natrvalo. Na 9 očiach je v oblasti makuly atrofía pigmentového epitelu a v dvoch očiach aj subretinálna fibróza.

Over the period between June 1992 and November 1997,15 subretinal neovascular membranes were removed in the Department of Ophthahnology of the Comenius University in Bratislava. The age of patients ranged between 57 and 72 years. In 13 patients the membrane was caused by age-related macular degeneration, in one patient the cause was choroiditis of unclear etiology and in one patient the membrane was caused probably by age related changes combined with myopic changes in the macular region. In three eyes only subretinal membrane was present. In all other eyes were also subretinal haemorrhages, hemophthalmus, or retinal detachment present. The visual acuity ranged between light perception md 1/50. After membrane removal the retina was tamponated by silicone oil in 10 eyes and by expanding gases in four eyes. In one eye peroperatively occured profuse bleeding from choroidal vessels and this procedure was interrupted. The follow-up period ranged form 5 - 52 months. During this period in nine patients were performed additional 12 surgical procedures. The visual acuity achieved is 0 in three eyes and in other eyes it ranged between hand movement and 5/50. Two eye atrophied. In one eye retinal detachment is present. Three eyes are still filled with silicone oil. In two of them the tamponade will be probably permanent. In nine eyes large areas of retinal pigment epithelivim atrophy are present and in two eyes also subretinal fibrous membranes are present.

Univ Kom LF Klinika oftalmológie Bratislava

5-years experiences with transvitreal removal of subretinal neovascular membranes

5-ročné skúsenosti s transvitreálnou extrakciou subretinálnych neovaskulárnych membrán = 5-years experiences with transvitreal removal of subretinal neovascular membranes /

5-years experiences with transvitreal removal of subretinal neovascular membranes /

Lit: 29

Souhrn en