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Surgical treatment experience of a macular hole in the conditions of the Regional State ophthalmologic clinical hospital of Public Health Ministry of Udmurt Republic

Purpose. To evaluate the effectiveness of surgical treatment of idiopathic macular hole in the conditions of the Regional State ophthalmologic clinical hospital of Public Health Ministry of Udmurt Republic. Methods. The study included 32 patients (32 eyes), 30 women, 2 men, aged 54 to 73 years with idiopathic macular hole. The patients were divided into three groups: the first – 8 people with a small diameter of macular hole (206.1±31.1 microns), the second – 8 people with a medium diameter of macular hole (333.5±53.6 microns), the third – 16 people with a large diameter of macular hole (564.7±96.6 microns). All of them underwent a 25-gauge vitrectomy with removal of the internal limiting membrane, drainage of the macular opening, instillation of 1-2 drops of platelet-rich autoplasma and subsequent air tamponade of the vitreal cavity. At the same time, the patients occupied a forced position of the body face down for the next 2 hours after the operation. Examinations were carried out before surgical treatment, at discharge from the hospital, 1 month and 1 year after the operation. Results. In the postoperative period, the closure of the macular hole was noted in 100 % of cases. In the first group, the visual acuity improved from 0.09±0.04 to 0.2±0.1 after 1 month and became 0.24±0.21 after 1 year after surgery (p < 0.05, U-test). In the second group, the visual acuity improved from 0.12±0.08 to 0.25±0.14 after 1 month and became 0.35±0.22 after 1 year after surgery (p<0.05, U-test). In the third group, the visual acuity improved from 0.08±0.05 to 0.13±0.05 after 1 month and became 0.16±0.15 after 1 year after surgery (p < 0.05, U-test). Conclusion. The results obtained indicate 100% effectiveness of the applied method of surgical treatment of macular hole, but to achieve even better results, it is necessary to search for new methods of treatment without removing the ILM. Key words: idiopathic macular hole, platelet-rich autoplasma, vitrectomy.