Saratov JOURNAL of Medical and Scientific Research

Surgical treatment of macular hole in myopia

Year: 2022, volume 18 Issue: №4 Pages: 647-650
Heading: Тhematic supplement Article type: Original article
Authors: Andreichenko О.А., Plotnikova Е.Е., Melnikova Yu.A., Andreichenko D.D.
Organization: Saratov State Medical University
Summary:

Abstract. Objective: evaluate the time of occurrence of macular holes and the results of surgical treatment in patients with myopia of varying degrees. Material and methods. 47 patients, 47 eyes with stage 3 and 4 macular holes were examined. Group 1 included 18 eyes with high myopia and eye length from 27.0 mm or more, group 2 included 17 patients with moderate myopia and eye length from 25.0 to 26.99 mm, group 3 (comparison) included 12 patients (12 eyes) with macular holes in mild myopia and emmetropia. Visual acuity in group 1 before treatment with maximum correction was 0.05±0.02, in group 2 it was 0.07±0.02, in group 3 it was 0.08±0.04. All patients underwent subtotal vitrectomy with removal of the posterior hyaloid membrane, peeling of the internal limiting membrane, closure of the rupture with platelet mass, and gas tamponade. Results. The average age of onset of macular hole in group 1 was 51 1±3.2 years, in group 2 — 57.1±2.4 years, in group 3 — 65.2±3.8 years. Closure of the gap was noted in 100% in group 1, in group 2 also in 100%, in group 3 in 83.3%. Visual acuity in group 1 after surgery increased to 0.1±0.05, in group 2 — up to 0.4±0.02, in group 3 — 0.5±0.05. Conclusion. Myopic refraction is a risk factor for the formation of a macular hole at an earlier age. Vitrectomy eliminates the traction effect on the macula during epiretinal membrane and closes the macular hole, while there is a stable increase in visual acuity for 6 months. Macular holes in high myopia require immediate surgical treatment as they lead to retinal detachment.

Bibliography:
1. Alpatov SA, Shchuko AG, Malyshev VV. Surgery for macular holes of the 20th and 23rd caliber. In: Macula-2008: Proceedings of the III All-Russian Seminar. Rostov-on-Don, 2008; p. 116-7.
2. Bayborodov YaV. 25G vitrectomy with silicone tamponade for the treatment of macular holes with retinal detachment in high myopia. In: Modern technologies for the treatment of vitreoretinal pathology — 2010: Collection of abstracts. M., 2010: p. 16-7.
3. Bayborodov YaV. Anatomical and functional results of the use of various options for the technique of surgical closure of macular holes. Modern Technologies in Ophthalmology. 2015; 5 (1): 22-4.
4. Gass JDM. Idiopathic senile macular hole. Its early stage and pathogenesis. Arch Ophthalmol. 1988; 106 (5): 629-39.
5. Johnson RN, Gass JDM. Idiopathic macular holes: observations, stages of formation, and implications for surgical intervention. Ophthalmology. 1988; 95 (7): 917-24.
6. Gass JDM. Reappraisal of biomicroscopic classification of stages of development of a macular hole. Am J Ophthalmol. 1995; 119 (6): 752-9.
7. Bely YuA, Tereshchenko AV, Shkvorchenko DO. A new approach to surgery for large idiopathic macular holes. Modern Technologies in Ophthalmology. 2015; 5 (1): 24-7.
8. Bikbov MM, Altynbayev UR, Gilmanshin TR, Chernov MS. Selecting the method of intraoperative closing of large idiopathic macular hole. 2010; (1): 25-8.
9. Jost BF, Hutton WL, Fuller DG, et al. Vitrectomy in eyes at risk for macular hole formation. Ophthalmology. 1990; 97 (7): 843-7.
10. Kelly NE, Wendel RT Vitreous surgery for idiopathic macular holes: results of a pilot study. Arch Ophthalmol. 1991; (106): 654-9.
11. BelyiYA, Tereshchenko AV, Shilov NM.etal. Comparative results of surgical treatment of large idiopathic macular holes. Acta Biomedica Scientifica. 2016; 1 (6): 19-23.
12. Poliner LS, Tornambe PE. Retinal pigment epitheliopathy after macular hole surgery. Ophthalmology. 1992; 99 (11): 1671 -7.
13. De Bustros S, Wendel RT. Vitrectomy for impending and full-thickness macular holes. Int Ophthalmol Clin. 1992; 32 (2): 139-52.

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