The article reviews the literature on one of the topical problems of vitreoretinal surgery - idiopathic macular holes. The history, concept, classification and diagnostics, as well as surgical and alternative treatment methods of macular holes are explored.

Aim. A retrospective analysis of the results of surgical treatment of large idiopathic macular holes depending on the technique of surgical intervention. Methods. The results of surgical treatment of 60 patients (60 eyes) with idiopathic macular holes with a diameter of more than 800 μm were studied in the Republican clinical ophthalmology hospital of Kazan. The average age of the patients was 66.2±5.37 (61-74) years. The patients underwent complex ophthalmological examination before the surgery and 10 days and 1 month after the surgery, including visometry, tonometry and optical coherence tomography. Patients were divided into two groups (30 subjects each), comparable in clinical and epidemiological parameters: group 1 - standard surgical tactics, group 2 - surgical treatment according to the method proposed by professor A.N. Samoylov. Visual acuity with correction before surgery in group 1 was 0.11±0.05, in group 2 - 0.12±0.06. Results. Ten days after the surgery, group 1 had anatomical closure in 23 (76.7%) patients, anatomical result was not achieved in 7 (23.3%) patients. In group 2, complete closure of the rupture was achieved in 27 (90.0%) patients, incomplete - in 3 (10.0%) patients. In 1 month in group 1, complete closure of the macular rupture was observed in 22 (73.3%) patients, in 8 (26.7%) patients the result was not achieved. In group 2, complete closure of the rupture was determined in 28 (93.3%) patients, incomplete closure - in 2 (6.7%) patients. Visual acuity 1 month after the surgery in group 1 was 0.15±0.08, and in group 2 - 0.32±0.11 (p <0.05). Conclusion. Surgical treatment of large idiopathic macular holes according to the modified technique of the inverted internal limiting membrane flap proposed by professor A.N. Samoylov, provides better anatomical and functional results in comparison with the standard technique (p <0.05).