Macular holes associated with diabetic tractional retinal detachments.
OBJECTIVE
Evaluation of surgical treatment of full-thickness macular holes secondary to diabetic tractional retinal detachments was conducted.


METHODS
A retrospective review of medical records, fluorescein angiograms, fundus photographs, optical coherence tomography images, and operative findings of six consecutive patients with full-thickness macular holes and diabetic tractional retinal detachments was completed. Each eye was treated with pars plana vitrectomy, tractional retinal detachment repair, membranectomy, indocyanine green-assisted internal limiting membrane peeling, and intraocular gas tamponade.


RESULTS
Surgical intervention resulted in the closure of all full-thickness macular holes. Mean best-corrected visual acuity was 20/250 preoperatively and 20/100 postoperatively, with all patients having improvement after a mean follow-up of 10 months.


CONCLUSIONS
Closure of tractional retinal detachments related to full-thickness macular holes can be achieved via pars plana vitrectomy, complete membranectomy, and intraocular gas. Vitrectomy with dissection of proliferative membranes helps to relieve the tractional forces responsible for full-thickness macular hole formation, enabling successful closure of the diabetic full-thickness macular holes and resulting in visual acuity improvement.
Mason
John O
JO
Department of Ophthalmology, Callahan Eye Foundation Hospital, University of Alabama at Birmingham School of Medicine, Birmingham, Alabama, USA.
Somaiya
Mamta D
MD
White
Milton F
MF
Vail
Rachel S
RS
D000328:Adult; D000368:Aged; D001485:Basement Membrane / Q000601:surgery; D003922:Diabetes Mellitus, Type 1 / Q000150:complications; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D003930:Diabetic Retinopathy / Q000150:complications* / Q000601:surgery; D005260:Female; D005466:Fluorocarbons / Q000008:administration & dosage; D006801:Humans; D008297:Male; D008875:Middle Aged; D012163:Retinal Detachment / Q000150:complications* / Q000601:surgery; D012167:Retinal Perforations / Q000209:etiology* / Q000601:surgery; D012189:Retrospective Studies; D013459:Sulfur Hexafluoride / Q000008:administration & dosage; D014792:Visual Acuity; D014821:Vitrectomy
D005466:Fluorocarbons; C042852:perflutren; D013459:Sulfur Hexafluoride