title: Surgical closure of macular hole using an absorbable macular plug.
abstract: 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.
authors.affiliation: LSU Eye Center, Louisiana State University Medical Center School of Medicine, New Orleans, USA.
authors.forename: G A
authors.initials: GA
authors.lastname: Peyman
authors.forename: M
authors.initials: M
authors.lastname: Daun
authors.forename: M D
authors.initials: MD
authors.lastname: Greve
authors.forename: D
authors.initials: D
authors.lastname: Yang
authors.forename: H
authors.initials: H
authors.lastname: Wafapoor
authors.forename: A
authors.initials: A
authors.lastname: Rifai
mesh_terms: 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
chemical_list: D005780:Gelatin