Visual field loss after vitrectomy for full-thickness macular holes.
OBJECTIVE
To report the results of a prospective study of the incidence of peripheral visual field loss after macular hole surgery.


METHODS
Prospectively, 30 eyes of 30 consecutive patients with full-thickness macular holes operated on between December 1995 and April 1996 had preoperative and postoperative Goldmann visual field tests. The surgical procedure consisted of three-port pars plana vitrectomy, posterior hyaloid removal, nonexpansile fluid-hexafluoroethane (C2F6) exchange, and, in 19 of 30 patients, autologous platelet injection, followed by face-down positioning.


RESULTS
Twenty-nine of these 30 cases were considered to be anatomic successes. Comparison of preoperative and postoperative visual fields disclosed that four patients (13%) had a peripheral scotoma, including one patient with stage 4 macular hole. Three other patients (10%) had a postoperative relative arcuate defect. Mean postoperative intraocular pressure was higher in the latter group. None of the patients complained of peripheral scotoma.


CONCLUSIONS
Overall, seven of 30 patients (23%) had a postoperative visual field defect. Two categories of scotomas were observed: peripheral and relative arcuate. The cause of peripheral visual field loss is unclear. Increased intraocular pressure may be the cause of relative arcuate scotomas.
Paques
M
M
Service d'Ophtalmologie, Hôpital Latiboisière, Université Paris VII, Paris, France.
Massin
P
P
Santiago
P Y
PY
Spielmann
A C
AC
Gaudric
A
A
D000328:Adult; D000368:Aged; D001792:Blood Platelets; D005260:Female; D005451:Fluorescein Angiography; D005654:Fundus Oculi; D006801:Humans; D007267:Injections; D008297:Male; D011446:Prospective Studies; D012167:Retinal Perforations / Q000175:diagnosis / Q000601:surgery*; D012607:Scotoma / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D058609:Visual Field Tests; D014794:Visual Fields; D014821:Vitrectomy / Q000009:adverse effects*