Purpose. To compare the effect of different types of intraocular tamponade and different types of postoperative positioning on the closure of idiopathic macular hole (IMH). Methods. Prospective randomized clinical trial enrolling 104 eyes of 100 patients (age, 57–87 years) undergoing MH surgery. All patients were operated on by an experienced surgeon using 25-gauge pars plana vitrectomy (PPV) and internal limiting membrane (ILM) peeling. Patients were randomized according to the type of intraocular tamponade and postoperative positioning into the following four groups: SF6 + nonsupine reading position (n = 26) (group 1), air + nonsupine reading position (n = 25) (group 2), air + prone position (n = 26) (group 3), or SF6 + prone position (n = 27) (group 4). The follow-up period was 6 months. Results. MH closure was achieved in 87 eyes (83.7 %) in the overall sample after the first surgery, with closure rates of 100%, 56%, 84.6%, and 92.6% in groups 1, 2, 3, and 4, respectively. The group 2 was significantly less successful compared to the other three groups ( p  < 0.05). MH of sizes ≤400 µm was closed in 97.2% of cases after the first surgery, with no significant differences between groups ( p  = 0.219). MH with sizes over 400 µm was closed in 70.9% of cases after the first surgery, with both groups with air tamponade being significantly less successful than group 1. The nonsupine reading position was subjected to a better subjective evaluation in terms of postoperative comfort and quality of sleep, with no differences between air and SF6 tamponade tolerance. Conclusion. PPV with ILM peeling, intraocular tamponade, and positioning remains the basic surgical approach in the treatment of IMH. For MH ≤ 400 µm, a high closure rate can be achieved by combining air tamponade and nonsupine reading position. For macular holes >400 µm, the greatest anatomical success can be achieved by using the SF6 tamponade in combination with the nonsupine reading position.

Aims. To evaluate the anatomical and functional results in patients with rhegmatogenous retinal detachment (RRD) who underwent 25-gauge pars plana vitrectomy (PPV) with gas tamponade. Materials and Methods. A retrospective evaluation of 126 eyes of 126 patients (79 men, 47 women) with RRD who underwent 25-gauge PPV with gas tamponade (13% C3F8 in 87 eyes, 20% SF6 in 39 eyes). 113 patients (89.7%), were operated on under local anaesthesia, 13 patients (10.3%) under general anaesthesia. Macula was detached in 85 eyes (67.5%). 53 eyes had pseudophakic RRD, 73 eyes were phakic. Anatomical success of the primary intervention, change in best corrected visual acuity (BCVA) and incidence of complications were assessed. An average follow-up period is 7.2 months (6-15). Results. With single operation, retinal attachment was achieved in 125 eyes (99.2%); the final anatomical success was 100%. The initial mean BCVA was 0.89 logMar (2.00 to 0.00); at the end of the follow-up period, it improved to 0.23logMAR (1.00 to -0.10), P < 0,0001. During the first post-intervention day, hypotony of the eye below 10 mmHg was observed in 1 patient (0.8%); on the contrary, intraocular pressure was temporarily increased to 25 mmHg and more in 36 patients (28.6%). Conclusion. The surgical treatment of RRD using 25-gauge PPV with expansive gas tamponade renders excellent anatomical results and improvement in BCVA. The incidence of complications and necessity of sclerotomy suturing are low.

Aim. A retrospective evaluation of the results of treatment of myopic choroidal neovascularization (mCNV) with intravitreal injections of ranibizumab in a pro re nata (PRN) regimen in three groups of patients distributed according to axial length. Methods. The paper presents a retrospective multicenter study carried out with the cooperation of several Departments of Ophthalmology in the Czech Republic. The study included 60 eyes of 60 patients suffering from mCNV, divided according to axial length into three groups. The first group consisted of 20 patients with an axial length of the eyes shorter than 28 mm (Group 1), the second group included 27 patients with axial lengths ranging from 28 mm to 29.81 mm (Group 2), and 13 patients had axial lengths longer than 30 mm (Group 3). All patients were first administered 3 initial intravitreal ranibizumab injections at monthly intervals (loading phase), and other injections were administered according to a PRN treatment regimen. Patients were evaluated before treatment and then at intervals of 3, 6, 9, and 12 months. The effect of ranibizumab treatment on the functional and morphological parameters of the affected eye was evaluated. Results. The average baseline BCVA ± SD in Group 1 was 52.6 ± 12.5 letters of ETDRS optotypes, and at the end of the one-year follow-up, it was 63.3 ± 11.8 letters. The average baseline of CRT ± SD in this group was 377.4 ± 80.0 μm, and in the 12th month, it was 311.1 ± 63.7 μm. The average baseline BCVA ± SD in Group 2 was 50.2 ± 9.0 ETDRS letters, and at the end of the follow-up, it was 60 ± 12.4 letters. The average baseline of CRT ± SD in Group 2 was 391.2 ± 85.2 μm, and in the 12th month, it was 323.9 ± 91.2 μm. In Group 3, the average baseline of BCVA was 48.5 ± 14.5 ETDRS letters, and at the end of the one-year follow-up, it was 55.7 ± 16.1 letters. The average baseline CRT ± SD for Group 3 was 342.1 ± 94.9 μm, and after 12 months, it was 287.8 ± 88.4 μm. An improvement of BCVA by ≥15 letters of ETDRS optotypes was achieved by 3 patients of 20 (15%) in Group 1, by 5 patients of 27 (18.5%) in Group 2, and by 3 patients of 13 (23.1%) in Group 3. All these changes were statistically significant in comparison with the input values p<0.05. Conclusion. Ranibizumab treatment in patients with mCNV in our study resulted in statistically significant improvement in BCVA and a decrease in CRT in all groups of patients. Our results from a routine clinical practice correspond with the results of large clinical studies; we confirm a particularly good effect of treatment in patients with axial lengths of the eye smaller than 28 mm.