Мicroinvasive 27 GA surgery of macular rupture in the eye with repeatedly operated recurrent total regmatogenic retinal detachment (clinical case)

One of the causes of low central vision in modern ophthalmology are various types of macular holes. For a long time, macular hole surgery was considered futile, with an extremely low prognosis for the effectiveness of treatment, improvement and stabilization of visual functions. The problem of surgical treatment of through macular holes is the most pressing. The causes of deterioration of central vision in patients who have undergone surgery for rhegmatogenous retinal detachment are known. Thus, against the background of the latest advances in surgery for retinal detachment and macular holes, the problem of obtaining a sufficiently high postoperative functional result does not lose its relevance. Objective. to assess the effectiveness of surgery for a large-diameter through macular hole against the background of repeatedly operated relapses of retinal detachment. Clinical case. Patient B., 51 years old. He came in August 2024 with complaints of a gray spot in front of the right eye, distortion of lines. From the anamnesis: repeatedly operated on for relapse of retinal detachment. Microsurgical (27 Ga) intervention with removal of epiretinal and internal limiting membranes was performed. Conclusions. Removal of epiretinal membrane and internal limiting membrane in patients previously operated on for retinal detachment, at the moment of development of retinal surgery technology, is the only effective surgical method of treatment. Clinically, this is expressed by improved visual acuity, a decrease in the diameter and subsequent disappearance of the central scotoma, a decrease in the thickness of the retina, scarless closure of the macular hole in the early and late periods of observation. Retinal detachment did not recur. Keywords: macular hole, retinal detachment, peeling of the internal limiting membrane, epiretinal fibrosis, vitreoretinal surgery