Microstructures of the foveolar region after surgery for idiopathic macular ruptures

Author: Vadim Stebnev (Russian Federation)

Co-authors: Sergey Stebnev, Neonilla Skladchikova, Tatyna Vaschenko

Purpose

To study the features of regenerative processes occurring in the microstructures of the foveolar region after successful surgery of the primary full-thickness macular holes (FTMH) by the method of "temporal inverted ILM flap".

Setting/Venue

Department of eye diseases of Samara State Medical University; Ophthalmic clinic "Eye Surgery", Samara, Russia

Methods

Using spectral optical coherence tomography (SOCT), the features of regenerative processes in the microstructures of the foveolar region were studied in 31 patients (32 eyes) with stage II-IV FTMH according to J. Gass (1995), who were successfully operated on for this reason.

Results

Regenerative processes of gradual restoration of microstructures of the foveolar region began from the first days after surgery and continued for 1 year. As a result, the U-shaped foveolar contour was restored, the central retinal thickness changed (from 399±61.4 to 195±61 microns, p<0.05); the external limiting membrane (ELM) and the ellipsoid zone (EZ) were completely restored in 27/32 (84.4%) and 23/32 (71.8%) eyes, respectively.

Conlusions

Regenerative processes in the microstructures of the foveolar zone are of a step-by-step nature and are traced for one year after the surgery of the primary FTMH by the method of "temporal inverted ILM flap". The essence of the processes: overlapping FTMH with flaps of ILM, filling its lumen with a "glial plug", restoring the ELM, EZ and interdigitative zones.