Successful closure of traumatic macular holes.
OBJECTIVE
To establish the efficacy of vitreoretinal surgery without the use of transforming growth factor-beta or autologous platelet concentrate in the repair of traumatic macular holes.


METHODS
This retrospective review consisted of 16 eyes from 16 consecutive patients treated by five vitreoretinal surgeons at a single institution between 1993 and 1997. Intervention included pars plana vitrectomy with creation of posterior vitreous detachment, placement of 14% to 16% C3F8 gas, and postoperative face-down positioning. Ten eyes received intraoperative autologous plasmin to facilitate formation of posterior vitreous detachment. Main outcome measures were anatomic closure rate and visual outcome.


RESULTS
Anatomic closure of the macular holes was achieved in 15 (94%) of 16 eyes, with an average follow-up of 7 months. Six (38%) eyes achieved visual acuity of 20/40 or better. Visual acuity improved by 2 or more lines in 11 (69%) of 16 eyes. The average preoperative logMAR-converted visual acuity of 20/175 improved to 20/60 postoperatively.


CONCLUSIONS
Traumatic macular holes can be closed successfully with substantial visual recovery without the use of transforming growth factor-beta or platelet concentrate.
Chow
D R
DR
McGill University, Montreal, Quebec, Canada.
Williams
G A
GA
Trese
M T
MT
Margherio
R R
RR
Ruby
A J
AJ
Ferrone
P J
PJ
D000293:Adolescent; D000328:Adult; D002648:Child; D005131:Eye Injuries / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D005260:Female; D005341:Fibrinolysin / Q000008:administration & dosage; D005343:Fibrinolytic Agents / Q000008:administration & dosage; D005466:Fluorocarbons / Q000008:administration & dosage; D005500:Follow-Up Studies; D006801:Humans; D007267:Injections; D007432:Intraoperative Period; D008266:Macula Lutea / Q000293:injuries*; D008297:Male; D008875:Middle Aged; D012167:Retinal Perforations / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity; D014821:Vitrectomy / Q000379:methods; D014822:Vitreous Body / Q000293:injuries; D020255:Vitreous Detachment / Q000175:diagnosis / Q000209:etiology / Q000601:surgery
D005343:Fibrinolytic Agents; D005466:Fluorocarbons; C042852:perflutren; D005341:Fibrinolysin