Saratov JOURNAL of Medical and Scientific Research

The effectiveness analysis of modern vitreo-retinal technologies for the treatment of different diameters macular holes

Year: 2021, volume 17 Issue: №3 Pages: 611-615
Heading: Тhematic supplement Article type: Original article
Authors: Andreychenko О.А., Plotnikova Е.Е., Gazdieva D.I., Gadzhimagomedova M.A.
Organization: Saratov State Medical University, University Clinical Hospital №2 (Clinic of Eye Diseases)

Objective: to compare anatomical and functional outcomes of operations in patients with through macular holes of different diameters. Material and Methods. 33 patients with different diameters macular holes were examined. The optical coherence tomograph Spectralis HRA-OCT (Heidelberg Engineering, Germany) was used in the study. The patients were divided into two groups: group 1 included 9 patients with holes of average diameter from 250 to 399 urn; group 2 contained patients with large-diameter holes. Group 2 was divided into subgroups A and B, depending on the size of the macular hole and the use of different techniques for closing the holes: group 2A consisted of 17 patients with a holes diameter from 400 to 600 urn; group 2B included 7 patients with holes from 670 to 1100 urn. All patients underwent vitrectomy using the STELLARIS and Eva systems. In group 1, peeling of the internal limiting membrane (ILM) was performed, using PRP (platelet-rich plasma); in group 2A, ILM peeling of a larger diameter was performed, air tamponade and PRP were used. During vitrectomy in group 2B, ILM peeling with the formation of a flap to close the macular hole and air-gas tamponade were performed. Results. Closure of the macular hole was achieved in all patients; only one patient required reoperation with additional ILM peeling and gas tamponade to close the hole. In group 1, the maximum corrected visual acuity (MCVA) increased from 0.1±0.04 to 0.5±0.1; in group 2Afrom 0.08±0.03 to 0.3±0.1. In group 2B, the MCVA increased from 0.06±0.02 to 0.08±0.03. Conclusion. There is a significant dependence of the functional results of vitrectomy on the macular hole diameter. The use of the inverted flap technique and the use of platelets increase the likelihood of closing the macular hole.

1. Shishkin MM, Pavlovsky OA, Larina EA. Surgical treatment of macular rupture. Ufa: Bashkir Encyclopedia, 2020; 136 p.
2. Shilov NM. Surgical treatment of large macular ruptures: PhD diss. Moscow, 2017; 147 p.
3. Kamenskikh TG, Kolbenev Ю, Melnikova YuA, Andre-ichenko OA. Optical coherence tomography with angiography in the analysis of the effectiveness of vitrectomy in patients with vit-reomacular traction syndrome. Ophthalmology 2020; 17 (1): 70-5.
4. Avetisov SE, Egorov EA, Moshetova LK, et al., eds. Ophthalmology: National Guidelines. Moscow, 2018, 2nd ed., reprint and add.
5. Daurov SK, Dolinina ON, Kamenskikh TG, et al. Computer analysis of epiretinal membrane parameters. Saratov Journal of Medical Scientific Research 2017; 13 (2): 350.
6. Susini A, Gastaud P. Macular holes that should not be operated (in French). J Fr Ophtalmol 2008; (31): 214-20.
7. Andrew N, Chan W, Tan M, Ebneter A. Modification of the Inverted Internal Limiting Membrane Flap Technique for the Treatment of Chronic and Large Macular Holes. Retina 2016; 36 (4): 834-7.
8. Smiddy WE, FeuerW, Cordahi G. Internal limiting membrane peeling in macular hole surgery. Ophthalmology 2001; (108): 1471-8.
9. Liggett PE, Skolik DS, Horio B, et al. Human autologous serum for the treatment of full-thickness macular holes. Ophthalmology 1995; 102: 1071-6.
10. Michalewska Z, Michalewski J, Adelman R, Nawroc-ki J. Inverted internal limiting membrane flap technique for large macular holes. Ophthalmology 2010; 117 (10): 2018-25.
11. Shin MK, Park KH, Park SW, et al. Perfluoro-n-oc-tane-assisted single-layered inverted internal limiting membrane flap technique for macular hole surgery. Retina 2014; 34 (9): 1905-10.

2021_03-2_611-615.pdf569.3 KB

No votes yet