Outpatient postoperative fluid-gas exchange after early failed vitrectomy surgery for macular hole.
BACKGROUND
Vitrectomy surgery with fluid-gas exchange and prone positioning has been shown to close macular holes and improve vision. In those eyes that have failed surgery, repeat vitrectomy has been advocated. As an alternative, the authors performed an outpatient postoperative fluid-gas exchange on eyes when the macular hole failed to close after vitrectomy surgery.


METHODS
The authors reviewed all cases of failed vitrectomy surgery for macular holes that underwent a postoperative fluid-gas exchange. Eyes were considered to have failed initial surgery if a rim of subretinal fluid surrounded an open full-thickness macular hole.


RESULTS
Twenty-three consecutive eyes underwent outpatient fluid-gas exchange 1 week to 8 weeks after vitrectomy surgery. In 17 eyes (74%), fluid-gas exchange resulted in flattening and closure of the macular hole. In all 17 eyes, visual acuity improved 2 or more lines, with 8 (35%) of the 23 eyes achieving 20/50 or better visual acuity.


CONCLUSIONS
Postoperative fluid-gas exchange may achieve successful closure of macular holes and improve vision in eyes that have failed surgery for full-thickness macular holes and should be considered as a cost-effective alternative to repeat vitrectomy.
Johnson
R N
RN
McDonald
H R
HR
Schatz
H
H
Ai
E
E
D000368:Aged; D000369:Aged, 80 and over; D000556:Ambulatory Surgical Procedures; D001826:Body Fluids; D005260:Female; D005466:Fluorocarbons / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care; D012167:Retinal Perforations / Q000503:physiopathology / Q000601:surgery*; D017211:Treatment Failure; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy
D005466:Fluorocarbons; C042852:perflutren