Prognostic factors for macular hole closure during surgical treatment of retinal detachment complicated by macular hole without membrane peeling

The desire to preserve the internal limiting membrane poses the challenge for researchers to develop personalized treatment tactics for retinal detachment with macular hole, depending on prognostic factors. The purpose of the study is to evaluate the influence of prognostic factors of anatomical success in patients after surgical treatment of retinal detachment with macular hole without membrane peeling. Material and methods. We studied the data of 20 patients (20 eyes) diagnosed with retinal detachment with macular hole stage C proliferative vitreoretinopathy. All patients were assessed for macular hole indices. Vitrectomy and endotamponade with silicone oil were performed. During the second operation, silicone was removed, the rupture was repaired with an inverted flap, and endotamponade was performed with a C2F6 gas-air mixture. The patients were divided into 2 groups: Group 1 (16 people / 16 eyes) — patients whose macular hole closed on its own; Group 2 (4 people / 4 eyes) — patients who underwent membrane peeling and repair of the gap with an inverted flap to close the hole at the second stage of treatment. Results. A significant difference between the groups was revealed when analyzing the macular hole index: among patients in whom the hole closed on its own, the indicator was 0.79 ± 0.07 and was higher than in patients who required plastic surgery at 1.65; traction index, in patients with a closed gap the indicator was 1.08 ± 0.13 and was 2.08 times higher. Conclusions. The study noted cases of convergence of the edges and complete closure of the macular hole without peeling of the internal limiting membrane during tamponade of the vitreal cavity with silicone oil. Indicators of the macular hole index and traction index of the hole can be used in determining personalized treatment tactics for patients with retinal detachment complicated by a macular hole.