An analysis of the efficacy of full-thickness macular hole surgical treatment with various multiplicity of intraocular fluid removal from the retinal surface at the stage of infusion solution-air exchange

Purpose. To compare the clinical-functional and anatomo-topographical results of macular hole surgical treatment with different multiplicity of intraocular fluid (IOF) removal from the retinal surface at the stage of infusion solution-air exchange. Methods. The present study was conducted at IRTC Eye Microsurgery Ekaterinburg Center from 2018 to 2020. The study included 2 groups of patients: in group 1 (single “drying” of the retina outside the fovea) the diameter of the macular hole (MH) in the narrow part ranged from 213 to 657 μm (504.5±23.4). In the control group (multiple “drying” of the retina) the diameter of MH in its narrow part was from 235 to 696 μm (496.43±25.7). The follow-up period in both groups ranged from 1 to 23 months (10.01±2.78). Clinical status and follow-up period in the compared groups did not differ significantly in all characteristics (p>0.05). Results. Macular hole closure after surgery by the end of follow-up was in 100 % of cases (120 eyes) in both groups. Best corrected visual acuity (BCVA) in the main group on the 1st day after surgery was 0.01±0.004, in the control group – 0.008±0.002 (p>0.05), 12 months later – 0.69±0.08 and 0.42±0.05, respectively (p <0.01). Conclusion. Repeated removal of IOF from the retinal surface at the stage of infusion solution-air exchange during MH surgery is inappropriate because it leads to atrophic changes of the central retinal neuroepithelium and decreased BCVA manifested in the remote follow-up period. Key words: macular hole, platelet-rich blood plasma, vitrectomy, retinal “drying”