helmholtzeyeinstituteРоссийский офтальмологический журналRussian Ophthalmological Journal2072-00762587-5760Real time Publishers10.21516/2072-0076-2026-19-3-174-177helmholtzeyeinstitute-2244Research ArticleОБЗОРЫ ЛИТЕРАТУРЫREVIEWSХирургическое лечение рефрактерных макулярных разрывовSurgical treatment of refractory macular holesФайзрахмановР. Р.FayzrahmanovR. R.

Ринат Рустамович Файзрахманов — д-р мед. наук, профессор, заведующий кафедрой глазных болезней.

Ул. Нижняя Первомайская, д. 70, Москва, 105203

Rinat R. Fayzrahmanov — Dr. of Med. Sci., professor, head of chair of eye diseases.

70, Nizhnyaya Pervomayskaya St., Moscow, 105203

КоноваловаК. И.KonovalovaK. I.

Карина Игоревна Коновалова — канд. мед. наук, доцент кафедры глазных болезней, врач-офтальмолог.

Ул. Нижняя Первомайская, д. 70, Москва, 105203

Karina I. Konovalova — Cand. of Med. Sci., associate professor, of chair of eye diseases.

70, Nizhnyaya Pervomayskaya St., Moscow, 105203

БородкинаВ. Н.BorodkinaV. N.

Вера Николаевна Бородкина — ординатор 1-го года кафедры глазных болезней.

Ул. Нижняя Первомайская, д. 70, Москва, 105203

Vera N. Borodkina — 1st year resident of chair of eye diseases.

70, Nizhnyaya Pervomayskaya St., Moscow, 105203

doc.saintveraxx@yandex.ruЕгороваА. И.EgorovaA. I.

Анастасия Ильинична Егорова — ординатор 2-го года кафедры глазных болезней.

Ул. Нижняя Первомайская, д. 70, Москва, 105203

Anastasia I. Egorova — 2nd year resident of chair of eye diseases.

70, Nizhnyaya Pervomayskaya St., Moscow, 105203

ИУВ ФГБУ «НМХЦ им. Н.И. Пирогова» Минздрава РоссииРоссияN.I. Pirogov National Medical and Surgical CenterRussian Federation202628092026193174177Copyright © Файзрахманов Р.Р., Коновалова К.И., Бородкина В.Н., Егорова А.И., 20262026Файзрахманов Р.Р., Коновалова К.И., Бородкина В.Н., Егорова А.И.Fayzrahmanov R.R., Konovalova K.I., Borodkina V.N., Egorova A.I.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://roj.igb.ru/jour/article/view/2244

Несмотря на множество существующих хирургических способов закрытия макулярного разрыва (МР), поиск наиболее эффективной хирургической тактики в случае рефрактерных МР представляет особый интерес. В данной статье представлен анализ литературы, освещающей методы закрытия рефрактерных МР с использованием свободного лоскута внутренней пограничной мембраны, аутологичного трансплантата нейроэпителия сетчатки, амниотической мембраны, фрагмента задней и передней капсулы хрусталика, а также гидродиссекции МР, выделены особенности анатомического и функционального исхода лечения с использованием указанных методик.

Despite the numerous existing surgical techniques for macular hole (MH) closure, the search for the most effective surgical approach for refractory MH is of particular interest. This article presents an analysis of the literature covering methods for refractory MH closure using a free internal limiting membrane flap, autologous retinal neuroepithelial graft, amniotic membrane, posterior and anterior lens capsule fragments, and MH hydrodissection. The anatomical and functional outcomes of these techniques are highlighted.

макулярный разрыввитреоретинальная хирургиягидродиссекция макулярного разрываmacular holevitreoretinal surgeryhydrodissection of macular holeникто из авторов не имеет финансовой заинтересованности в представленных материалах или методахno author has a financial or property interest in any material or method mentionedReferencesKhan TH, Rizvi SF, Mahmood SA, Feroz L. Treatment of chronic large and persistent macular hole by a new technique in a Tertiary Care Hospital. Pak J Med Sci. 2021 Jul-Aug; 37 (4): 979–82. doi: 10.12669/pjms.37.4.3618Khan TH, Rizvi SF, Mahmood SA, Feroz L. Treatment of chronic large and persistent macular hole by a new technique in a Tertiary Care Hospital. Pak J Med Sci. 2021 Jul-Aug; 37 (4): 979–82. doi: 10.12669/pjms.37.4.3618Frisina R, Gius I, Tozzi L, Midena E. Refractory full thickness macular hole: current surgical management. Eye (Lond). 2022 Jul; 36 (7): 1344–54. doi: 10.1038/s41433-020-01330-yFrisina R, Gius I, Tozzi L, Midena E. Refractory full thickness macular hole: current surgical management. Eye (Lond). 2022 Jul; 36 (7): 1344–54. doi: 10.1038/s41433-020-01330-yLumi X, Mahnic M, Petrovski BÉ, Petrovski G. Outcomes of vitrectomy for long-duration macular hole. J Clin Med. 2020 Feb 6; 9 (2): 444. doi: 10.3390/jcm9020444Lumi X, Mahnic M, Petrovski BÉ, Petrovski G. Outcomes of vitrectomy for long-duration macular hole. J Clin Med. 2020 Feb 6; 9 (2): 444. doi: 10.3390/jcm9020444Premi E, Donati S, Azzi L, et al. Macular holes: Main clinical presentations, diagnosis, and therapies. J Ophthalmol. 2022 Apr 11; 2022: 2270861. doi: 10.1155/2022/2270861Premi E, Donati S, Azzi L, et al. Macular holes: Main clinical presentations, diagnosis, and therapies. J Ophthalmol. 2022 Apr 11; 2022: 2270861. doi: 10.1155/2022/2270861Imai M, Iijima H, Gotoh T, Tsukahara S. Optical coherence tomography of successfully repaired idiopathic macular holes. Am J Ophthalmol. 1999 Nov; 128 (5): 621–7. doi: 10.1016/s0002-9394(99)00200-7Imai M, Iijima H, Gotoh T, Tsukahara S. Optical coherence tomography of successfully repaired idiopathic macular holes. Am J Ophthalmol. 1999 Nov; 128 (5): 621–7. doi: 10.1016/s0002-9394(99)00200-7Шпак А.А., Шкворченко Д.О., Шарафетдинов И.Х., Юханова О.А. Прогнозирование результатов хирургического лечения идиопатического макулярного разрыва. Офтальмохирургия. 2015; 2: 55–61.Shpak A.A., Shkvorchenko D.O., Sharafetdinov I.K., Yuhanova O.A. Predicting the results of surgical treatment of idiopathic macular hole. Fyodorov journal of ophthalmic surgery. 2015; (2): 55–61 (In Russ.).Файзрахманов Р.Р., Павловский О.А., Ларина Е.А. Хирургическое лечение пациентов с неустраненным макулярным разрывом. Вестник НМХЦ им. Н.И. Пирогова. 2019; 14 (2): 98–104. https://doi.org/10.25881/BPNMSC.2019.41.78.021Fayzrahmanov R.R., Pavlovskiy O.A., Larina E.A. Modern methods of operative intervention of patients with macular hole. Bulletin of Pirogov national medical & surgical center. 2019; 14 (2): 98–104 (In Russ.). https://doi.org/10.25881/BPNMSC.2019.41.78.021Cai Y, Liu WB, Wei D, et al. Hydromassage of macular hole edges for large and persistent full-thickness macular holes. Int J Ophthalmol. 2024 Mar 18; 17 (3): 551–7. doi: 10.18240/ijo.2024.03.18Cai Y, Liu WB, Wei D, et al. Hydromassage of macular hole edges for large and persistent full-thickness macular holes. Int J Ophthalmol. 2024 Mar 18; 17 (3): 551–7. doi: 10.18240/ijo.2024.03.18Zhang H, Li Y, Chen G, Han F, Jiang W. Human amniotic membrane graft for refractory macular hole: A single-arm meta-analysis and systematic review. J Fr Ophtalmol. 2023 Mar; 46 (3): 276–86. doi: 10.1016/j.jfo.2022.07.001Zhang H, Li Y, Chen G, Han F, Jiang W. Human amniotic membrane graft for refractory macular hole: A single-arm meta-analysis and systematic review. J Fr Ophtalmol. 2023 Mar; 46 (3): 276–86. doi: 10.1016/j.jfo.2022.07.001Morizane Y, Shiraga F, Kimura Sh, et al. Autologous transplantation of the internal limiting membrane for refractory macular holes. J Ophthalmol. 2014; 157 (4): 861–9. doi: 10.1016/j.ajo.2013.12.028Morizane Y, Shiraga F, Kimura Sh, et al. Autologous transplantation of the internal limiting membrane for refractory macular holes. J Ophthalmol. 2014; 157 (4): 861–9. doi: 10.1016/j.ajo.2013.12.028Grewal DS, Mahmoud TH. Autologous neurosensory retinal free flap for closure of refractory myopic macular holes. JAMA Ophthalmol. 2016 Feb; 134 (2): 229–30. doi: 10.1001/jamaophthalmol.2015.5237Grewal DS, Mahmoud TH. Autologous neurosensory retinal free flap for closure of refractory myopic macular holes. JAMA Ophthalmol. 2016 Feb; 134 (2): 229–30. doi: 10.1001/jamaophthalmol.2015.5237Rizzo S, Caporossi T, Tartaro R, et al. A human amniotic membrane plug to promote retinal breaks repair and recurrent macular hole closure. Retina. 2019 Oct;39 Suppl 1: S95-S103. doi: 10.1097/IAE.0000000000002320Rizzo S, Caporossi T, Tartaro R, et al. A human amniotic membrane plug to promote retinal breaks repair and recurrent macular hole closure. Retina. 2019 Oct;39 Suppl 1: S95-S103. doi: 10.1097/IAE.0000000000002320Chen SN, Yang CM. Lens capsular flap transplantation in the management of refractory macular hole from multiple etiologies. Retina. 2016 Jan; 36 (1): 163–70. doi: 10.1097/IAE.0000000000000674Chen SN, Yang CM. Lens capsular flap transplantation in the management of refractory macular hole from multiple etiologies. Retina. 2016 Jan; 36 (1): 163–70. doi: 10.1097/IAE.0000000000000674Oliver A, Wojcik EJ. Macular detachment for treatment of persistent macular hole. Ophthalmic Surg Lasers Imaging. 2011 Nov–Dec; 42 (6): 516-8. doi: 10.3928/15428877-20110825-01Oliver A, Wojcik EJ. Macular detachment for treatment of persistent macular hole. Ophthalmic Surg Lasers Imaging. 2011 Nov–Dec; 42 (6): 516-8. doi: 10.3928/15428877-20110825-01Файзрахманов Р.Р., Ларина Е.А., Павловский О.А. Оперативное лечение ранее не закрывшихся макулярных разрывов. Офтальмология. 2020; 17 (3): 368–74. doi: 10.18008/1816-5095-2020-3-368-374Faizrakhmanov R.R., Larina E.A., Pavlovskii O.A. Surgical treatment of previously unclosed macular holes. Ophthalmology in Russia. 2020; 17 (3): 368–74 (In Russ.). doi: 10.18008/1816-5095-2020-3-368-374Grewal DS, Charles S, Parolini B, Kadonosono K, Mahmoud TH. Autologous retinal transplant for refractory macular holes: Multicenter International Collaborative Study Group. Ophthalmology. 2019 Oct; 126 (10): 1399–408. doi: 10.1016/j.ophtha.2019.01.027Grewal DS, Charles S, Parolini B, Kadonosono K, Mahmoud TH. Autologous retinal transplant for refractory macular holes: Multicenter International Collaborative Study Group. Ophthalmology. 2019 Oct; 126 (10): 1399–408. doi: 10.1016/j.ophtha.2019.01.027Tabandeh H. Vascularization and reperfusion of autologous retinal transplant for giant macular holes. JAMA Ophthalmol. 2020 Mar 1; 138 (3): 305–9. doi: 10.1001/jamaophthalmol.2019.5733Tabandeh H. Vascularization and reperfusion of autologous retinal transplant for giant macular holes. JAMA Ophthalmol. 2020 Mar 1; 138 (3): 305–9. doi: 10.1001/jamaophthalmol.2019.5733Rojas-Juárez S, Cisneros-Cortés J, Ramirez-Estudillo A, Velez-Montoya R. Autologous full-thickness retinal transplant for refractory large macular holes. Int J Retina Vitreous. 2020 Nov 23; 6 (1): 60. doi: 10.1186/s40942-020-00266-5Rojas-Juárez S, Cisneros-Cortés J, Ramirez-Estudillo A, Velez-Montoya R. Autologous full-thickness retinal transplant for refractory large macular holes. Int J Retina Vitreous. 2020 Nov 23; 6 (1): 60. doi: 10.1186/s40942-020-00266-5Caporossi T, Pacini B, Bacherini D, et al. Human amniotic membrane plug to promote failed macular hole closure. Scientific Reports. 2020; 10 (1): 18264. doi: 10.1038/s41598-020-75292-2Caporossi T, Pacini B, Bacherini D, et al. Human amniotic membrane plug to promote failed macular hole closure. Scientific Reports. 2020; 10 (1): 18264. doi: 10.1038/s41598-020-75292-2Szigiato AA, Gilani F, Walsh MK, Mandelcorn ED, Muni RH. Induction of macular detachment for the treatment of persistent or recurrent idiopathic macular holes. Retina. 2016 Sep; 36 (9): 1694–8. doi: 10.1097/IAE.0000000000000977Szigiato AA, Gilani F, Walsh MK, Mandelcorn ED, Muni RH. Induction of macular detachment for the treatment of persistent or recurrent idiopathic macular holes. Retina. 2016 Sep; 36 (9): 1694–8. doi: 10.1097/IAE.0000000000000977Ruban A, Lytvynchuk L, Zolnikova A, Richard G. Efficiency of the hydraulic centripetal macular displacement technique in the treatment of traumatic full-thickness macular holes. Retina. 2019 Oct; 39 Suppl 1: S74-S83. doi: 10.1097/IAE.0000000000001929Ruban A, Lytvynchuk L, Zolnikova A, Richard G. Efficiency of the hydraulic centripetal macular displacement technique in the treatment of traumatic full-thickness macular holes. Retina. 2019 Oct; 39 Suppl 1: S74-S83. doi: 10.1097/IAE.0000000000001929Felfeli T, Mandelcorn ED. Macular hole hydrodissection: Surgical technique for the treatment of persistent, chronic, and large macular holes. Retina. 2019 Apr; 39 (4): 743–52. doi: 10.1097/IAE.0000000000002013Felfeli T, Mandelcorn ED. Macular hole hydrodissection: Surgical technique for the treatment of persistent, chronic, and large macular holes. Retina. 2019 Apr; 39 (4): 743–52. doi: 10.1097/IAE.0000000000002013Русановская А.В. Хирургическое лечение хронических макулярных разрывов путем гидравлической мобилизации центральных отделов сетчатки. Современные технологии в офтальмологии. 2019; 1: 158–61. doi: 10.25276/2312-4911-2019-1-158-161Rusanovskaja A.V. Surgical treatment of chronic macular holes by hydraulic mobilization of the central areas of the retina. Sovremennye tehnologii v oftal’mologii. 2019; 1: 158–61 (In Russ.). doi: 10.25276/2312-4911-2019-1-158-161

The authors declare that there are no conflicts of interest present.