Variants of the reparative activity of the foveolar zone in the closure of the macular hole by autoplasty in internal limiting membrane

Abstract

Purpose. Propose a new technique of operation macular discontinuity, which is based on the preservation of the internal limiting membrane (ILM), and to assess the dynamics of retinal morphological and functional parameters for different embodiments of wound healing. Material and methods. The results of surgical treatment of 240 patients (240 eyes) with the diagnosis of macular hole were analyzed. Group 1 (120 eyes) – patients who underwent surgical treatment according to the standard method. Group 2 (120 eyes) – patients who were operated on using the original method with partial exfoliation of ILM in the Central zone. All patients underwent ophthalmological examination before and after surgery, including visometry, biomicroscopy, ophthalmoscopy and OCT. Results. Preoperative functional parameters of the retina in patients of both groups were comparable. During the study, two types of closure of macular tears were identified. When studying the morphological changes in the «pseudocyst» type of macular rupture repair in patients of both groups, a more pronounced resistance of the neuroretinal tissue is observed in patients of the 1st group. In the 2nd group, a more pronounced dynamics of a decrease in the morphological parameters of the hyporeflexive defect was revealed throughout the entire observation period. With the complete closure of the macular gap, a higher rate of regression of edema of neuroepithelial tissue is observed in patients of the 2nd group. Conclusion. Based on this study, we can conclude that during this technique, the ILM is preserved, which reduces the risk of intraoperative damage to the retinal layers. Key words: macular rupture, peeling, internal boundary membrane, optical coherence tomography.