Macular microstructure changes after endovitreal macular hole surgery

ABSTRACT Purpose. To study macular microstructural changes after idiopathic full-thickness macular hole (IMH) sur gery. Material and methods. Fifty-seven eyes with IMH of 53 patients were examined by the spectral-domain optical coherence tomography. Subtotal 25G vitrectomy with an internal limiting membrane peeling with the subsequent drainage of subretinal fluid and the air tamponade of vitrous cavity was performed in all cases. The examinations were carried out preoperatively and 1, 3 and 6 months after successful sur gery. Results. In postoperative follow-up of 1 month the external limiting membrane (ELM) was clearly visible in 54 eyes, but there was a photoreceptor inner/outer segment junction «defect» (42 cases – group 1), or an ELM deflection which contacted the pigment epithelium (12 cases – group 2). The ELM deflection was not detected 3 months later, but there was the same «defect» as in the group 1. In both groups 3 and 6 months later the size of the «defect» reduced gradually and in several cases it was not present any more. The size of the «defect» was smaller in the group 1 compared to the group 2 in all follow-up (P<0.01). In 3 eyes (group 3) the intact ELM was absent and other structural changes were pronounced 1 month after surgery. In these cases no changes were observed 3 and 6 months after the oper ation. Conclusion. After the IMH closure the outer retinal layers gradually restore their structure, that is confirmed by a photoreceptor inner/outer segment junction restoration. The ELM integrity evidently plays an important role in the process of photoreceptor repair

Evaluation of safety of binary tamponade of vitreous cavity in surgical treatment of retinal detachment

ABSTRACT Purpose. To assess the safety of retinal detachment surgery employing double endotamponade with PFCL and silicone oil for 30 days. Material and methods. Inclusion criteria: retinal detachment with retinal breaks located in both upper and lower retina and/or with residual severe proliferative vitreoretinopathy. In the study group (26 eyes) the surgery was finished with double tamponade with PFCL and silicone oil. In the control group (20 eyes) the surgery was finished with silicone oil tamponade. Tamponade agents were removed 1 month later. Examinations included optical coherence tomography (OCT) and microperimetry along with standard eye examination. Results. Retinal reattachment by means of one surgical procedure was achieved in 81% in the study group and in 65% in the control group. There was no significant difference in BCVA between the two groups. OCT data analysis showed no significant differences between the groups in the thickness of outer and inner nuclear layers. Microperimetry detected no significant differences in light sensitivity between the groups. Conclusion. Double endotamponade with PFCL and silicone oil seems to be a safe method for the treatment of complicated retinal detachments