Surgical treatment of full-thickness macular holes using autologous serum

In this review, the opinions of different authors on the problem of non-full thickness macular holes are discussed in detail. Currently, there are three different approaches to the management of this condition. Dynamic observation allows assessing the degree of their progression, to determine some or other anatomical indicators which influence the functional state of the retina and visual function. Pharmacological vitreolysis in some cases allows eliminating vertical and tangential traction in a least invasive mannor. To resolve this problem in a radical way is possible by surgical treatment posterior vitrectomy, but this is also related to certain surgical risks, and does not always lead to an increase in visual acuity. As a rule, it is recommended to patients with a significant decrease in visual acuity. Currently, indications for surgical treatment of patients with high visual function are ambiguous.

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Treatment of Full-Thickness Macular Holes With Autologous Serum

Japanese Journal of Ophthalmology ◽

10.1016/s0021-5155(97)00055-5 ◽

1997 ◽

Vol 41 (5) ◽

pp. 332-338 ◽

Cited By ~ 20

Author(s):

S Kusaka

Keyword(s):

Autologous Serum ◽

Full Thickness ◽

Macular Holes

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A Retrospective Analysis of the Results of Microinvasive Posterior Vitrectomy in the Surgical Treatment of Non-Full Thickness Macular Holes

Ophthalmology in Russia ◽

10.18008/1816-5095-2018-2s-239-245 ◽

2018 ◽

Vol 15 (2S) ◽

pp. 239-245 ◽

Cited By ~ 1

Author(s):

Y. V. Bayborodov ◽

K. S. Zhogolev ◽

L. I. Balashevich ◽

I. E. Panova ◽

D. R. Mirsaitova

Keyword(s):

Visual Acuity ◽

Surgical Treatment ◽

Retrospective Analysis ◽

Retinal Thickness ◽

Maximum Diameter ◽

Full Thickness ◽

Ellipsoid Zone ◽

Corrected Visual Acuity ◽

Macular Holes ◽

Before And After

Purpose:to study the effectiveness of the posterior microinvasive vitrectomy in the surgical treatment of non-full thickness macular holes on the basis of the retrospective analysis of the retina changes, identified by OCT, and functional outcomes of surgical treatment.Patients and Methods. A retrospective analysis of outcomes of posterior microinvasive vitrectomy was performed in 30 patients operated about non-full thickness macular holes. The following features were assessed: maximum diameter of the non-full thickness macular holes, the diameter at the base of the hole, the minimum thickness of the retina before and after operation, the maximum thickness of the retina before and after surgery. In addition, the configuration of the hole edges before surgery, the presence of intraretinal cysts before and after surgery, the integrity of the ellipsoid zone of the photoreceptors before and after the operation and the restoration of fovea centralis as a result of surgical treatment were assessed.Results. As a result of surgical treatment the closure of non-full thickness macular holes was reached in all cases. The most corrected visual acuity in the postoperative period was ranged from 0.1 to 1.0 (0,66 ± 0,04). The visual acuity improved in 20 cases (64.5%), remained at the same level in 8 cases (25.8%) and decreased in 3 cases (9.6%, in 1 case due to the development of cataracts). The results of correlation analysis has allowed to establish correlation between the initial BCVA and the maximum retinal thickness (R = –0.4), and residual retinal thickness in the area of the hole (R = –0.3). The increase in visual acuity after surgical treatment significantly affected the recovery of the ellipsoid zone of the photoreceptors (RD = 0.833), regression of the retinal thickness (R = 0.42). In addition, the initial diameter of non-full thickness macular holes, both external and at the base, also had an impact on the increase in BCVA (R = –0.3 and R = –0.25, respectively).Conclusion. Posterior microinvasive vitrectomy in the surgical treatment of non-full thickness macular holes is a highly effective method of treatment, as evidenced by the closure of the defect and improvement or stabilization of the most corrected visual acuity 90.4% cases. On the basis of the retrospective analysis it is found that the most significant increase in the most corrected visual acuity was increased in patients with low visual acuity. The recovery of the ellipsoid zone of photoreceptors, regression of the retinal thickness and the diameter of non-full thickness macular holes, both external and at the base mostly influences nn the recovery of the most corrected visual acuity.

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The concept of the foveola anatomical reconstruction in the surgical treatment of full-thickness macular tears using intraoperative OCT control

Ophthalmology journal ◽

10.17816/ov10312-17 ◽

2017 ◽

Vol 10 (3) ◽

pp. 12-17 ◽

Cited By ~ 1

Author(s):

Jaroslav V Bayborodov

Keyword(s):

Surgical Treatment ◽

Anatomical Reconstruction ◽

Full Thickness ◽

Minimally Invasive Approach ◽

Macular Hole Surgery ◽

Invasive Approach ◽

Anatomical Structures ◽

Macular Holes ◽

Vitreomacular Interface ◽

Intraoperative Oct

Background. The concept of foveola anatomical reconstruction in surgical treatment of macular holes is a minimally invasive approach based on sparing principles of visualization and removal of transparent structures. Purpose. To estimate the practical value of high-resolution intraoperative OCT control (IOСT) at surgical treatment of macular holes. Materials and methods. The study included 95 patients (95 eyes) with macular holes from 400 to 900 microns in diameter, being during the period from September 2015 to October 2016. Results. IOСT control increases the anatomical and functional success of macular hole surgery, allowing determining more accurately the vitreomacular interface anatomical structures during the procedure and making more precise choice of tamponade agent to the end of it. Conclusion. The proposed foveola anatomical reconstruction in surgical treatment of full-thickness macular holes enhanced by intraoperative OCT control provides high functional and anatomic postoperative retinal indices. (For citation: Bayborodov YaV. The concept of the foveola anatomical reconstruction in the surgical treatment of full-thickness macular tears using intraoperative OCT control. Ophthalmology Journal. 2017;10(3):12-17. doi: 10.17816/OV10312-17).

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