Evaluation of the inner layers of retinal tissue morphology changes in the remote period depending on the implementation of macular hole plastic in patients with macular hole against the background of retinal detachment

The combination of macular hole and retinal detachment can cause irreversible deterioration of visual functions and requires emergency surgical intervention, but the issue of methods and timing of hole closure when planning surgical treatment is controversial. Material and methods. Forty patients (40 eyes) diagnosed with macular hole and rhegmatogenous retinal detachment were examined and operated. Patients of the 1st group at the first stage underwent vitrectomy, no attempts were made to block the hole, silicone tamponade. During the second intervention, we removed silicone from the vitreous cavity, and, in 4 cases, surgery of the hole with an inverted flap. The operation was completed with C2F6 endotamponade. Patients of the 2nd group at the first stage underwent vitrectomy, plastic surgery of the hole with an inverted flap and tamponade of the vitreous cavity with silicone. Results. After one and a half years of observation, when assessing the data in the volume of the inner layers of retinal tissue in the temporal zone of the parafovea, the reliable difference remained at the level of 1.59 times, the indicator was 0.172 ± 0.012 mm3 (p = 0.042 compared with the data of patients in group 1). Conclusion. When considering the technique of surgical intervention for macular rupture against the background of retinal detachment, the main goal is to preserve the integrity of the retinal tissue in the central zone. Keywords: macular hole, retinal detouchment, membranepiling, silicone oil tamponade