COMPARATIVE RESULTS OF SURGICAL TREATMENT OF LARGE IDIOPATHIC MACULAR HOLES

Abstract

The goal is to evaluate the effectiveness of the developed technique of the gradual forming of the internal limiting membrane (ML) fragment in the treatment of large macular holes (MH) in comparison with the standard methodology (using classical maculorhexis and rapprochement of MH edges by using of vacuum aspiration). Materials and methods: we observed 137patients (103 women, 34 men) aged from 54 to 78years with large MH (over 400 ßm). Duration of MH ranged from 3 to 60 months. All the patients were divided into groups: 1 (new methodology) and 2 (standard method), and sub-groups: 1a and 2a - patients with MH with a minimum diameter 400-650 μm; 1b and 2b - patients with MH with a minimum diameter more than 650 μm. The new technique is performed in several stages, during which several series of 1LM "petals" removal are made, leaving an intact area on the MH edge. The last ILM "petal" or fragment is inverted and placed on the MH. Results: 1n subgroup 1a, there was a statistically significant increase in best corrected visual acuity (BCVA) during all follow-up with the most pronounced growth in the first 6 months (from 0.15 ± 0.06 to 0.55 ± 0.14) (p < 0.05). 1n subgroup 1b a statistically significant increase in mean values of BCVA was also observed especially during first 6 month (from 0.13 ± 0.06 to 0.36 ± 0.12) (p < 0.05). In group 2 (a, b) BCVA was significantly lower (p < 0.05). Conclusion: the new technique allows to reach higher functional-anatomical results in surgical treatment of MH.

Keywords

• idiopathic macular hole
• internal limiting membrane
• surgical treatment