Офтальмохирургия (Dec 2015)
MACULAR MICROSTRUCTURE CHANGES AFTER ENDOVITREAL MACULAR HOLE SURGERY
Abstract
Purpose. To study macular microstructural changes after idiopathic full-thickness macular hole (IMH) surgery.Material and methods. Fifty-seven eyes with IMH of 53 patients were examined by the spectral-domain optical coherence tomography. Subtotal 25G vitrectomy with an internal limiting membrane peeling with the subsequent drainage of subretinal fluid and the air tamponade of vitrous cavity was performed in all cases. The examinations were carried out preoperatively and 1, 3 and 6 months after successful surgery.Results. In postoperative follow-up of 1 month the external limiting membrane (ELM) was clearly visible in 54 eyes, but there was a photoreceptor inner/outer segment junction «defect» (42 cases – group 1), or an ELM deflection which contacted the pigment epithelium (12 cases – group 2). The ELM deflection was not detected 3 months later, but there was the same «defect» as in the group 1. In both groups 3 and 6 months later the size of the «defect» reduced gradually and in several cases it was not present any more. The size of the «defect» was smaller in the group 1 compared to the group 2 in all follow-up (P<0.01). In 3 eyes (group 3) the intact ELM was absent and other structural changes were pronounced 1 month after surgery. In these cases no changes were observed 3 and 6 months after the operation. Conclusion. After the IMH closure the outer retinal layers gradually restore their structure, that is confirmed by a photoreceptor inner/outer segment junction restoration. The ELM integrity evidently plays an important role in the process of photoreceptor repair.><0,01). In 3 eyes (group 3) the intact ELM was absent and other structural changes were pronounced 1 month after surgery. In these cases no changes were observed 3 and 6 months after the operation.Conclusion. After the IMH closure the outer retinal layers gradually restore their structure, that is confirmed by a photoreceptor inner/outer segment junction restoration. The ELM integrity evidently plays an important role in the process of photoreceptor repair.
