The use of a retinal valve during autotransplantation in the surgical treatment of retinal detachment complicated by a through macular hole

Surgical treatment of combined pathology, regmatogenic retinal detachment complicated by macular hole, has been described repeatedly in the literature. Vitrectomy with removal of the ILM showed high anatomical and functional results. However, if we take into account the literature in recent years, these methods can lead to a progressive decrease in visual functions in the long term. Thus, the negative effects of removing the inner boundary membrane, which causes damage to Muller cells, are shown. The use of autologous retina transplantation in the treatment of idiopathic macular holes has been widely used in Russian and foreign literature in recent years. Possible difficulties are usually associated with flap mobilization, namely separation of chorioretinal junctions, hemorrhages from the choroid, capture and mobilization of the flap without damaging it. In the case of retinal detachment, the use of already «mobilized» tissue may be quite promising to close the central opening. The aim of the work is to use the retinal valve during autotransplantation in the surgical treatment of regmatogenic retinal detachment complicated by a through-the-wall macular hole. Material and methods. Two patients were operated on with a diagnosis of retinal detachment recurrence, proliferative vitreoretinopathy, stage C, and macular hole. The technique of the operation. The valve was mobilized using scissors. With tweezers to remove the inner boundary membrane along the Ecgardt, the mobilized flap was moved into the macular zone under perfluorodecalin. Results. In both cases, it was possible to achieve a complete fit of the retina and block the macular openings. Visual acuity, upon achieving the anatomical effect, remained at the same level in both patients, due to repeated interventions performed earlier. Conclusion. The use of a retinal valve during autotransplantation in surgery for retinal detachment complicated by a through-the-wall macular rupture eliminates traumatic peeling of the inner boundary membrane and may be the method of choice for primary intervention in the treatment of combined pathology. Keywords: transplantation, autologous retina, macular hole