Macular hole repair with minimal vitrectomy.
OBJECTIVE
Conventional macular hole surgery usually involves removing 80% of the intraocular contents to repair a hole a few hundred micrometers in diameter. Although the success rate for conventional surgery is good, it may be possible to reduce the number of complications with less invasive surgery.


METHODS
A newly designed microspatula knife was used to dissect the connection between the vitreous and the retina previously delineated by optical coherence tomography. The posterior vitreous was not stripped from the retinal surface. Limited vitrectomy over the hole was performed to create a space for a gas bubble.


RESULTS
The macular holes in three eyes of three patients were closed with this technique with no operative or postoperative complications after a mean follow-up of 8.7 months. The mean change in visual acuity was 6.3 lines.


CONCLUSIONS
It is possible to repair macular holes by using optical coherence tomography to guide the dissection of the vitreous from the macular hole followed by limited vitrectomy. By using a less invasive approach, it may be possible to repair macular holes in less operative time and with fewer complications.
Spaide
Richard F
RF
and the LuEsther T. Mertz Retina Research Laboratory, Manhattan Eye, Ear, and Throat Hospital, New York, New York 10021, USA. rickspaide@yahoo.com
D000368:Aged; D005260:Female; D005466:Fluorocarbons / Q000627:therapeutic use; D006801:Humans; D007368:Interferometry; D008027:Light; D008875:Middle Aged; D012167:Retinal Perforations / Q000175:diagnosis / Q000601:surgery*; D014054:Tomography; D016896:Treatment Outcome; D014792:Visual Acuity; D014821:Vitrectomy / Q000295:instrumentation / Q000379:methods*
D005466:Fluorocarbons; C042852:perflutren