Estrategias Actuales para el Tratamiento Quirúrgico del Agujero Macular
Marcelo Zas, Marcos Mendaro, Mariano Cotic, Adriana Nieva, Elio Dilascio, Eugenia Páez Soria, María de los Ángeles Cenoz, Agustina Piczman, Pablo Chiaradía
Citation Information :
Zas M, Mendaro M, Cotic M, Nieva A, Dilascio E, Soria EP, Cenoz MD, Piczman A, Chiaradía P. Estrategias Actuales para el Tratamiento Quirúrgico del Agujero Macular. 2023; 16 (4):27-33.
El agujero macular es un defecto retinal de espesor completo que afecta al centro foveal y produce la pérdida de la agudeza visual central. Numerosos estudios permitieron conocer en mayor profundidad la anatomía e histopatogenia del mismo. La tomografía de coherencia óptica permitió clasificar los agujeros maculares en diferentes estadios y estimar el pronóstico quirúrgico, mediante la medición del diámetro del mismo. En 1991 se propuso para su tratamiento la vitrectomía por pars plana combinada con el desprendimiento de la corteza vítrea posterior y el tamponaje con gas, hasta ese momento se la consideraba una patología prácticamente intratable. Posteriormente se instaló el pelado de la membrana limitante interna como adyuvante de la vitrectomía, incrementando la eficacia del tratamiento. Gracias al avance de la tecnología la tasa de éxito en cuanto al cierre del agujero macular fue aumentando progresivamente. Esta revisión aborda las técnicas que disponemos en la actualidad para el manejo de esta enfermedad e intenta brindar sugerencias para el abordaje quirúrgico en cada caso.
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