Macular hole surgery without routine membrane excision or use of adjuvants.
OBJECTIVE
To present results of macular hole surgery without adjunctive treatment or routine membrane dissection, but with a long duration tamponade.


METHODS
Fifty-one consecutive eyes underwent surgery with vitrectomy. Membrane peeling was performed only when traction was obvious. Pure perfluoropropane gas was injected as a tamponade followed by prone positioning for two weeks. All eyes were examined with scanning laser ophthalmoscopy (SLO) before and after surgery.


RESULTS
The macular hole was closed successfully in 48 eyes (94%) after one procedure. Visual acuity improved to 0.50 or more in 18 eyes (35%). Improvement of two or more lines was achieved in 35 eyes (69%). Two eyes developed retinal detachments and two eyes showed post-operative visual field defects previously reported after macular hole surgery.


CONCLUSIONS
In this series the results and complication rates compare favourably with other reports of macular hole surgery. However, in contrast to many previous studies, membrane peeling was not done. The extent and long duration of the gas tamponade was thought to be important for the surgical success.
Byhr
E
E
Department of Ophthalmology, Sahlgren's University Hospital, Gothenburg, Sweden. eva.byhr@sahlgrenska.se
Lindblom
B
B
D000368:Aged; D000369:Aged, 80 and over; D001485:Basement Membrane / Q000601:surgery; D005260:Female; D005466:Fluorocarbons / Q000008:administration & dosage*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D013508:Ophthalmologic Surgical Procedures; D009887:Ophthalmoscopy; D011183:Postoperative Complications; D016684:Prone Position; D011446:Prospective Studies; D012167:Retinal Perforations / Q000601:surgery*; D016896:Treatment Outcome; D014792:Visual Acuity; D014821:Vitrectomy
D005466:Fluorocarbons; C042852:perflutren