Surgical closure of macular hole using an absorbable macular plug.
BACKGROUND
The surgical management of macular holes has been a subject of controversy in recent years. Various techniques such as vitrectomy, membrane peeling, and gas tamponade with or without transforming growth factor-beta 2, and recently the use of autologous platelets have produced closure rates from 58% to 96%, depending on the stage of the hole.


METHODS
The authors present preliminary results in a study of 19 consecutive patients with stage 3 or stage 4 macular hole who underwent vitrectomy followed by placement of an absorbable partially cross-linked gelatin plug in the macular hole. The vitreous cavity was filled with a nonexpanding gas or air alone; the patient was instructed to maintain prone positioning for 2-3 days.


RESULTS
Anatomic attachment of the edges of the macular hole was achieved in 19 out of 19 patients with a minimum follow-up period of 6 months (average 11.5 months).


CONCLUSIONS
A cross-linked gelatin plug can effectively reattach the edges of macular holes of stages 3 and 4. Its use is recommended only in macular holes in high myopes with posterior staphyloma or recurrent macular hole.
Peyman
G A
GA
LSU Eye Center, Louisiana State University Medical Center School of Medicine, New Orleans, USA.
Daun
M
M
Greve
M D
MD
Yang
D
D
Wafapoor
H
H
Rifai
A
A
D000042:Absorption; D000328:Adult; D000368:Aged; D004867:Equipment Design; D005260:Female; D005780:Gelatin / Q000493:pharmacokinetics; D006801:Humans; D008297:Male; D008488:Medical Illustration; D008875:Middle Aged; D011446:Prospective Studies; D019736:Prostheses and Implants; D012167:Retinal Perforations / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy
D005780:Gelatin