ophthalmologyОфтальмологияOphthalmology in Russia1816-50952500-0845Ophthalmology10.18008/1816-5095-2023-4-664-674ophthalmology-2235Research ArticleОФТАЛЬМОХИРУРГИЯOPHTHALMOSURGERYОптимизация выбора фракции, богатой тромбоцитами плазмы, для хирургического лечения макулярных разрывовOptimization of Platelet-Rich Plasma Fraction Selection for Surgical Treatment of Macular Holeshttps://orcid.org/0000-0001-9569-5906КазайкинВ. Н.KazaykinV. N.

Казайкин Виктор Николаевич доктор медицинских наук, врач-офтальмохирург, ведущий научный сотрудник

ул. Академика Бардина, 4а, Екатеринбург, 620149

Kazaykin Viktor N. MD, ophthalmic surgeon, leading researcher

Akademician Bardin, 4a, Yekaterinburg, 620149

https://orcid.org/0000-0002-5196-2168ДемченкоН. С.DemchenkoN. S.

Демченко Надежда Сергеевна кандидат медицинских наук, врач клинической лабораторной диагностики и лабораторной генетики

ул. Академика Бардина, 4а, Екатеринбург, 620149

Demchenko Nadezhda S. PhD, doctor of Clinical laboratory diagnostics and laboratory genetics

Akademician Bardin, 4A, Yekaterinburg, 620149

https://orcid.org/0000-0002-1848-1207КлейменовА. Ю.KleimenovA. Yu.

Клейменов Андрей Юрьевич врач-офтальмохирург

ул. Академика Бардина, 4а, Екатеринбург, 620149

Kleimenov Andrey Yu. ophthalmic surgeon

Akademician Bardin, 4a, Yekaterinburg, 620149

АО «Екатеринбургский центр МНТК “Микрохирургия глаза”»РоссияEye Microsurgery Ekaterinburg CenterRussian Federation202327122023204664674Copyright © Казайкин В.Н., Демченко Н.С., Клейменов А.Ю., 20232023Казайкин В.Н., Демченко Н.С., Клейменов А.Ю.Kazaykin V.N., Demchenko N.S., Kleimenov A.Y.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.ophthalmojournal.com/opht/article/view/2235

Цель: на основе клинического и морфофункционального анализа восстановления сетчатки и оценки клеточного состава, богатой тромбоцитами плазмы, определить ее оптимальную фракцию для хирургического лечения макулярного разрыва. Пациенты и методы. В настоящем исследовании представлены результаты 120 случаев хирургического лечения глаз с макулярным разрывом. Пациенты были разделены на 2 группы. В 1-й группе (60 глаз) применена разработанная в нашей клинике технология без использования послеоперационной тампонады витреальной полости, но с применением аутологичной богатой тромбоцитами плазмы (БоТП), во 2-й — традиционная технология лечения макулярных разрывов (60 глаз). Проанализирован клеточный состав БоТП 30 пациентов. Результаты. Через 2 месяца после операции у 119 пациентов наблюдалось восстановление всех слоев сетчатки в области макулярного разрыва и зафиксирована положительная динамика остроты зрения в сравнении с дооперационным периодом. После наблюдения в течение 6 месяцев после операции случаи рецидива макулярного разрыва не выявлены. Заключение. Лечебное значение БоТП заключается в тампонирующем и регенераторном эффекте. По результатам настоящего исследования для хирургии макулярного разрыва рационально использовать плазму из слоя чистой богатой тромбоцитами плазмы (P-PRP), которая содержит достаточное количество тромбоцитов, способных оказать положительный терапевтический эффект, и минимальное количество лейкоцитов, способных выполнить функции иммунной защиты и репарации сетчатки и окружающих тканей.

Objective: based on clinical and morpho — functional analysis of retinal restoration and assessment of the cellular composition of platelet-rich plasma, to determine its optimal fraction for surgical treatment of macular hole. Materials and methods. This study presents the results of 120 cases of surgical treatment of eyes with macular hole. The patients were divided into 2 groups. In the 1st group (60 eyes), the technology developed in our clinic was used without the use of postoperative tamponade of the vitreal cavity and the use of autologous platelet-rich plasma (PRP), in the 2nd — traditional technology for the treatment of macular hole s (60 eyes). The cellular composition of the PRP of 30 patients was analyzed. Results. 2 months after surgery, 119 patients had the restoration of all retinal layers in the macular hole area and positive dynamics of visual acuity was recorded in comparion with the preoperative period. After observation for 6 months after surgery, cases of recurrence of macular hole were not detected. Conclusion. The therapeutic value of BoTP lies in the tamponing and regenerative effect. According to the results of this study, for maculrupture surgery, it is rational to use plasma from a layer of pure platelet-rich plasma (P-PRP), which contains a sufficient number of platelets capable of having a positive therapeutic effect, and a minimum number of leukocytes capable of performing the functions of immune protion and repair of the retiand surrounding tissues.

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The authors declare that there are no conflicts of interest present.