Comparative analysis of morphological and functional parameters of the macular zone in patients after surgical treatment of rhegmatogenous retinal detachment complicated by macular hole

    Abstract

    Original article

    Comparative analysis of morphological and functional parameters of the macular zone in patients after surgical treatment of rhegmatogenous retinal detachment complicated by macular hole

    R.R. Fayzrakhmanov, E.E. Vaganova, E.A. Larina, O.L. Sekhina

    Institute of Advanced Training of Physicians N.I. Pirogov National Medical Surgical Center, Moscow, Russian Federation

    N.I. Pirogov National Medical Surgical Center, Moscow, Russian Federation

    Relevance. The occurrence of retinal detachment in eyes with high myopia in combination with macular hole is caused by «reverse traction», when the thinned retina does not have time to stretch due to anatomical mismatch. In modern research, much attention is paid to the technique of closing the macular hole while maintaining the internal limiting membrane.

    Purpose. To evaluate effectiveness of patients with retinal detachment and macular hole proliferative vitreoretinopathy stage C surgical treatment, depending on the method of closure of the macular hole.

    Material and methods. Data of 22 patients (22 eyes), divided into 2 groups were evaluated. Patients of the 1st group (11 patients) underwent surgical treatment with closure of the macular hole with an inverted flap of the inner limiting membrane. Patients of the 2nd group (11 patients) underwent surgical treatment with the closure of the macular hole by the technique of mechanical convergence of the edges and the use of autological conditioned plasma. The vitreal cavity was plugged with 1300 silicone oil and removed after 43±6 days.

    Results. After first surgical intervention, retinal reattachment was achieved in all patients. In the 1st group, the macular hole was blocked in 100% of cases, in the 2nd — in 81% of cases (9 patients). In group 1, BCVA increased to 0.1±0.04, and in group 2, to 0.8±0.03. When examining patients of the 2nd group a month after the removal of silicone, in 64% of cases (7 patients), according to optical coherence tomography, the formation of an epiretinal membrane and the appearance of a traction effect on the macular zone were observed.

    Conclusion. So, the closure of the macular hole using the inverted flap method made it possible to achieve better anatomical and functional results, and the high incidence of epiretinal membrane formation indicates the need for membranopiling when closing the macular hole in such patients due to the high risk of progression of postoperative proliferative vitreoretinopathy.

    Key words: rhegmatogenous retinal detachment, macular hole, inverted flap inner limiting membrane, autologous conditioned plasma, epiretinal membrane

    For citation: Fayzrakhmanov R.R., Vaganova E.E., Larina E.A., Sekhina O.L. Comparative analysis of morphological and functional parameters of the macular zone in patients after surgical treatment of rhegmatogenous retinal detachment complicated by macular hole. Fyodorov Journal of Ophthalmic Surgery. 2025;1(143): 44–48.

    doi: 10.25276/0235-4160-2025-1-44-48

    Corresponding author: Elena E. Vaganova, vaganova.e.e@gmail.com