Surgical Treatment of Previously Unclosed Macular Holes
Open Access
- 24 September 2020
- journal article
- Published by PE Polunina Elizareta Gennadievna in Ophthalmology in Russia
- Vol. 17 (3), 368-374
- https://doi.org/10.18008/1816-5095-2020-3-368-374
Abstract
Macular holes are the most often pathology leading to reduced vision among persons after 60 years. The macular hole is the acquired disease which is a defect of a foveola part of retina on all thickness from an internal limiting membrane to an external segment of a photoreceptor layer. The standard method of treatment is surgery method: a microinvasive vitrectomy with membrane peeling in macular area. There is a number of the techniques increasing efficiency of operative intervention. Even in case of successful surgical intervention macular holes are not always closed.The purpose: development and assessment of morphological parameters of the central retina with a new surgical method of closing earlier operated macula hole using a free flap.Material and methods. 40 patients (40 eyes, 28 women and 12 men) had participated in this study. All patients were operated about macular hole with negative anatomic result. By technology which were used earlier, patients were divided into 3 studied groups (with PRP mass using, with introverted flap using, with mechanical matching of edges of a hole). The main method of research was the optical coherent tomography. All patients were operated by an original technique. It’s purpose was a closing of earlier operated rigid macular hole using a free flap.Results. The defect of a photoreceptor component was closed with an additional expansion of earlier created macular rexis in patients of the 1st and 3rd groups at reoperation. The earlier created flap of an internal limiting membrane was used in patients of the 2nd group. In the analysis of dependence of change of visual acuity from morphological parameters of a macular hole after primary surgical treatment the inverse correlation relation from diameter of a macular hole on small and big radiuses is revealed. The highest visual acuity after a reoperation was reached at patients of the second group.Conclusions. It is necessary to consider the technique which was used earlier, diameter of a macular hole on small and big radiuses, postoperative edema in a parafovea zone for planning the surgical treatment and a forecast of functional results.Keywords
This publication has 8 references indexed in Scilit:
- Anti-VEGF dosing regimen for neovascular age-related macular degeneration treatmentVestnik oftal'mologii, 2018
- REPEATED SURGICAL CLOSURE OF THE MACULAR TEARS USING THE “FREE FLAP” TECHNIQUE OF THE INTERNAL BORDER MEMBRANETambov University Reports. Series: Natural and Technical Sciences, 2017
- Efficiency of vitrectomy in combination with internal limiting membrane peeling associated with the gas-air tamponade of the vitreous cavity at the advanced stage of proliferative diabetic retinopathyFyodorov journal of ophthalmic surgery, 2017
- LENS CAPSULAR FLAP TRANSPLANTATION IN THE MANAGEMENT OF REFRACTORY MACULAR HOLE FROM MULTIPLE ETIOLOGIESRetina, 2016
- Autologous Transplantation of the Internal Limiting Membrane for Refractory Macular HolesAmerican Journal of Ophthalmology, 2014
- ERG assessment of the functional activity of the retina in following the surgical closure of idiopathic macular holesOphthalmology Reports, 2013
- Idiopathic vitreomacular traction and macular hole: a comprehensive review of pathophysiology, diagnosis, and treatmentEye, 2013
- Anatomical Outcomes of Surgery for Idiopathic Macular Hole as Determined by Optical Coherence TomographyAmerican Journal of Ophthalmology, 2002