Abstract

Actual. Recently, additional microtraumatization of neuroretinal tissue has been proven during removal of the internal limiting membrane (ILM) due to its close connection with the inner layers of the retina and with Muller cells. These factors may influence functional results after surgery for closure of macular hole. Purpose of the study was to propose a new technique for surgery for macular hole, which is based on the preservation of ILM and to assess the dynamics of the functional parameters of the retina. Material and methods. The results OCT of 60 patients (60 eyes) with the diagnosis of macular hole were analyzed. Group 1 (30 eyes) – patients who underwent surgical treatment introvert flap. Group 2 (30 eyes) – patients who were operated on using the original method with partial exfoliation of ILM in the Central zone. All patients underwent standard ophthalmological examination before and after surgery, including visometry, biomicroscopy, ophthalmoscopy, and OCT. Results. The preoperative functional parameters of the retina were comparable in both groups of patients. The study identified 3 types of macular hole closure. When studying morphological changes in macular rupture repair by the «pseudocyst» type in patients of both groups, it shows a more pronounced resistance of neuroretinal tissue in patients of group 1. In the 2nd group, a more pronounced dynamics of reducing the morphological parameters of the hyporeflective defect was revealed throughout the entire observation period. When the macular hole is completely closed, there is a higher rate of regression of neuroepithelial tissue edema in group 2 patients. Non-closure of the macular hole was observed only in group 1 patients, and in this type of repair, there was a deterioration in morphological parameters. 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. Keywords: macular hole, pilling, microperimetry.

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