Anatomic and functional results of vitrectomy and long-term intraocular tamponade for stage 2 macular holes.
OBJECTIVE
To investigate the results of pars plana vitrectomy combined with long-term intraocular tamponade in patients with a stage 2 macular hole.


METHODS
In a retrospective study, 50 consecutive eyes operated on for stage 2 macular hole were reviewed. The surgical technique included pars plana vitrectomy, separation of the posterior hyaloid, and intraocular tamponade with either 12.5% perfluropropane (C(3)F(8)) gas or silicone oil. Patients treated with C(3)F(8) were instructed to keep face-down positioning for 3 or 4 weeks. Removal of silicone oil took place 4 or 5 weeks after the vitrectomy.


RESULTS
Closure of the macular hole was achieved in all 50 eyes after one operation. The mean postoperative best-corrected distance visual acuity was 20/32 (range, 20/63-20/20), with 49 eyes (98%) having a postoperative visual acuity of 20/50 or better. Visual acuity improved in all eyes postoperatively, with a mean gain of 4.84 +/- 1.95 ETDRS lines.


CONCLUSIONS
For stage 2 macular holes, vitrectomy combined with long-term intraocular tamponade can result in a very favorable anatomic and functional outcome that is as good as or better than the results described for other modalities. This approach simplifies the surgical technique, and both adjuvant-related complications and potential retinal damage related to internal limiting membrane peeling or use of indocyanine green are avoided.
Dori
Dalia
D
Department of Ophthalmology, University Hospital of Zurich, Switzerland. g_dori@bezeqint.net
Thoelen
Adelheid M
AM
Akalp
Fatma
F
Bernasconi
Paolo P
PP
Messmer
Elmar P
EP
D000328:Adult; D000368:Aged; D004396:Coloring Agents; D005260:Female; D005466:Fluorocarbons / Q000627:therapeutic use*; D006801:Humans; D007208:Indocyanine Green; D008297:Male; D008875:Middle Aged; D016684:Prone Position; D012160:Retina / Q000033:anatomy & histology*; D012167:Retinal Perforations / Q000145:classification / Q000503:physiopathology / Q000601:surgery*; D012189:Retrospective Studies; D012827:Silicone Oils / Q000627:therapeutic use*; D014792:Visual Acuity / Q000502:physiology*; D014821:Vitrectomy
D004396:Coloring Agents; D005466:Fluorocarbons; D012827:Silicone Oils; C042852:perflutren; D007208:Indocyanine Green