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).
This review of the literature is devoted to the comparison of tonometers based on various operating principles, their advantages and disadvantages. The principles of operation of each considered in the review tonometer are discussed. The features of the structure and mechanisms for measuring the intraocular pressure of various tonometers are highlighted, on the basis of which the anatomical features and other factors that have the greatest impact on the reliability of measurement and accounting of the data obtained in clinical practice are determined.
Vitreoretinal surgery is an actively developing area of modern ophthalmic surgery. Intravitreal interventions in the central retina with large full-thickness macular holes deserve special attention. This article provides an overview of the scientific literature published in journals recommended by the Higher Attestation Commission, also presented in the scientific databases Scopus, PubMed, dedicated to modern techniques to the surgical treatment of large full-thickness macular holes. The main methods for closing defects in the macular area today are the use of various modifications of the inverted internal limiting membrane flap technique and the application of autologous platelet rich plasma in a macular hole. These techniques provide high anatomical and functional outcomes. Modifications of the inverted internal limiting membrane flap technique demonstrated effectiveness in such complex clinical situations as recurrent macular holes, concomitant high myopia, retinal detachment. Over the past 10 years, data on the use of autologous platelet-rich plasma for this group of patients appeared in the scientific literature. More accurate surgical procedures are required for the use of this technique compared with the standard methods, but this technique is applicable in all patients, does not require additional manipulations (blood sampling and centrifugation), additional equipment. Vitreoretinal interventions with the use of platelet-rich plasma are characterized by relative simplicity and ease of carrying out surgical procedures. However, it is important to consider the possibility of pseudouveitis development, the need for additional equipment. Since both of these methods demonstrate good anatomical results, the problem of choosing a technique in a particular clinical case remains. It was clear that the method of surgical intervention should be chosen, taking into account possible disadvantages and limitations to the method, as well as the skills of an ophthalmic surgeon. The lack of a unified approach to macular hole surgery encourages researchers to improve surgical techniques, develop and implement new modifications of surgical approaches.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.