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

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.