Long-term outcomes of macular hole surgery with triamcinolone acetonide-assisted internal limiting membrane peeling.
OBJECTIVE
To report long-term anatomical and functional results after pars plana vitrectomy with internal limiting membrane (ILM) peeling using triamcinolone acetonide (TA) for idiopathic macular holes.


METHODS
Prospective, consecutive, interventional case series.


METHODS
Ninety-six eyes of 94 patients who underwent macular hole surgery with TA-assisted ILM peeling were included in the study. Patients with <12 months of follow-up were excluded. On 82 phakic eyes, simultaneous phacoemulsification with intraocular lens implantation was performed. Follow-up examinations included clinical examination, determination of best-corrected visual acuity, intraocular pressure measurement, optical coherence tomography, Goldmann perimetry, and static perimetry using the Humphrey visual field analyzer. The main outcome measures were postoperative visual acuity, macular hole status, and postoperative complications.


RESULTS
The mean follow-up period was 17 months (range, 12-30 months). TA improved visualization of the ILM, and the peeled area was seen as an area lacking white specks. All macular holes successfully closed after primary surgery. Mean visual acuity improved from 0.26 to 1.0 at the final visit (P < 0.0001), with 90 eyes (94%) having improvement of visual acuity. Postoperative complications included retinal detachment in one patient and transient intraocular pressure elevation in five patients.


CONCLUSIONS
Although transient intraocular pressure elevation was observed in a few patients, the use of TA in macular hole surgery may be an effective and safe technique to facilitate visualization of the ILM and can lead to good long-term anatomical and functional results.
Kumagai
Kazuyuki
K
Shinjo Ophthalmologic Institute, Miyazaki, Japan. ganka@kamiiida-hp.jp
Furukawa
Mariko
M
Ogino
Nobuchika
N
Larson
Eric
E
Uemura
Akinori
A
D000368:Aged; D000369:Aged, 80 and over; D001485:Basement Membrane / Q000601:surgery; D019773:Epiretinal Membrane / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids; D006801:Humans; D007429:Intraocular Pressure; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012167:Retinal Perforations / Q000601:surgery*; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D014222:Triamcinolone Acetonide; D014792:Visual Acuity; D058609:Visual Field Tests; D014821:Vitrectomy
D005938:Glucocorticoids; D014222:Triamcinolone Acetonide