helmholtzeyeinstituteРоссийский офтальмологический журналRussian Ophthalmological Journal2072-00762587-5760Real time Publishers10.21516/2072-0076-2023-16-1-22-28helmholtzeyeinstitute-1163Research ArticleКЛИНИЧЕСКИЕ ИССЛЕДОВАНИЯCLINICAL STUDIESМеханизмы терапевтического эффекта богатой тромбоцитами плазмы в хирургии макулярного разрываMechanisms of the therapeutic effect of platelet-rich plasma in macular hole surgeryДемченкоН. С.DemchenkoN. S.

Надежда Сергеевна Демченко — канд. мед. наук, врач клинико-диагностической лаборатории

ул. Академика Бардина, д. 4а, Екатеринбург, 620149

Nadezhda S. Demchenko — Cand. of Med. Sci., doctor of clinical diagnostic laboratory

4a, Academician Bardin St., Ekaterinburg, 620149

medichkan@mail.ruКлейменовА. Ю.KleimenovA. Yu.

Андрей Юрьевич Клейменов — врач-офтальмолог, хирург витреоретинального отделения

ул. Академика Бардина, д. 4а, Екатеринбург, 620149

Andrey Yu. Kleimenov — ophthalmology, ophthalmic surgeon, vitreoretinal department

4a, Academician Bardin St., Ekaterinburg, 620149

КазайкинВ. Н.KazaykinV. N.

Виктор Николаевич Казайкин — д-р мед. наук, ведущий научный сотрудник витреоретинального отделения

ул. Академика Бардина, д. 4а, Екатеринбург, 620149

Viktor N. Kazaykin — Dr. of Med. Sci., leading researcher, vitreoretinal department

4a, Academician Bardin St., Ekaterinburg, 620149

АО «Екатеринбургский центр МНТК "Микрохирургия глаза"»РоссияEkaterinburg Eye Microsurgery CenterRussian Federation2023140320231612228Copyright © Демченко Н.С., Клейменов А.Ю., Казайкин В.Н., 20232023Демченко Н.С., Клейменов А.Ю., Казайкин В.Н.Demchenko N.S., Kleimenov A.Y., Kazaykin V.N.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://roj.igb.ru/jour/article/view/1163

Цель работы — описать механизмы лечебного воздействия на сетчатку компонентов богатой тромбоцитами плазмы (БоТП) в хирургии макулярных разрывов (МР). Материал и методы. Представлены результаты применения аутологичной БоТП в 36 случаях хирургического лечения глаз с идиопатическим сквозным МР размером от 96 до 932 мкм (в среднем 546,4 ± 49,8 мкм). Острота зрения с коррекцией до операции составляла от 0,04 до 0,2 (0,09 ± 0,01). Количество клеточных элементов во фракциях БоТП определялось на гематологическом анализаторе Sysmex XS-500i (Германия). Результаты. Через 2 мес после операции у всех пациентов наблюдалось восстановление всех слоев сетчатки в области МР, острота зрения с коррекцией повысилась до 0,2–0,6 (0,40 ± 0,04). В течение 6 мес после операции у 35 (97 %) пациентов рецидивов МР не было. Предложена методика оценки качества БоТП по содержанию в ней больших тромбоцитов. Описаны основные механизмы лечебного действия БоТП. Заключение. Накопление данных об эффективном применении компонентов БоТП позволит планировать более широкое ее использование в лечении дегенеративных, инфекционных, посттравматических и других нарушений структур глаза. Оценка качества БоТП по содержанию в ней функционально активных тромбоцитов поможет более эффективно применять БоТП в офтальмологии.

Purpose: to describe the mechanisms of the therapeutic effect of platelet-rich plasma (PRP) components on the retina in macular hole (MH) surgery. Material and methods. The results of autologous PRP use in 36 cases of surgical treatment of eyes with idiopathic full-thickness MH sized 96 to 932 mm (ave. 546.4 ± 49.8 mm) are presented. Corrected visual acuity before surgery was 0.04 to 0.2 (0.09 ± 0.01). The quantity of cell elements in PRP fractions was determined using a hematological analyzer Sysmex XS-500i (Germany). Results: 2 months after the operation, all retinal layers in the MH area were found to restore in all patients, who showed an increase in visual acuity to 0.2–0.6 (0.40 ± 0.04). 35 patients (97 %) had no MH relapse over the 6-month post-surgery period. A technique was proposed to evaluate the quality of PRP by the presence of large platelets. The mechanisms of the therapeutic effect of PRP components on the retina were presented. Conclusion. The collection of data on the effectiveness of PRP components is instrumental in planning its wider use in the treatment of degenerative, infectious, post-traumatic and other disorders of eye structures. The evaluation of PRP quality by the content of functionally active platelets will also contribute to more effective PRP use in ophthalmology.

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