25-gauge vitrectomy using sulfur hexafluoride and no prone positioning for repair of macular holes.
OBJECTIVE
To report on the outcomes of 25-gauge pars plana vitrectomy using sulfur hexafluoride and no prone positioning for repair of macular holes.


METHODS
Retrospective case series of 44 consecutive patients who underwent pars plana vitrectomy with internal limiting membrane peeling for repair of stages 2 to 4 idiopathic macular holes using 20% to 30% sulfur hexafluoride. No postoperative prone positioning or gas augmentation was used.


RESULTS
The macular hole closure rate was 88.6%. There were no differences in the macular hole closure rates between phakic and pseudophakic patients (21 of 23 vs. 17 of 21, respectively) or among stages 2, 3, and 4 macular holes (12 of 13, 20 of 23, and 7 of 8, respectively). In eyes successfully operated on, visual acuity improved from 0.61 logarithm of the minimal angle of resolution (logMAR) (20 of 82) preoperatively to 0.483 logMAR (20 of 61) at 1 month and 0.396 logMAR (20 of 50) at a mean final follow-up of 10.8 months. Adverse effects were elevation of intraocular pressure to >30 mmHg in 7 (13.6%) of 44 patients on the first postoperative day, postoperative retinal detachments in 2 (4.5%) of 44 patients, and progression of cataract requiring cataract surgery in 7 (30.4%) of 23 phakic patients during follow-up.


CONCLUSIONS
Macular hole closure rates similar to those achieved using pars plana vitrectomy with perfluoropropane and prone positioning can be achieved using sutureless 25-gauge vitrectomy with sulfur hexafluoride tamponade and no prone positioning for both phakic and pseudophakic patients.
Cullen Eye Institute, Baylor College of Medicine, 6565 Fannin, Houston, TX 77030, USA.
Petros E
PE
Carvounis
Andrew C
AC
Kopel
Derek P
DP
Kuhl
Jordan
J
Heffez
Kathryn
K
Pepple
Eric R
ER
Holz
D000368:Aged; D002386:Cataract / Q000503:physiopathology; D018450:Disease Progression; D019773:Epiretinal Membrane / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007429:Intraocular Pressure; D007430:Intraoperative Care; D008297:Male; D011184:Postoperative Period; D011187:Posture; D012163:Retinal Detachment / Q000209:etiology; D012167:Retinal Perforations / Q000503:physiopathology / Q000601:surgery*; D012189:Retrospective Studies; D013459:Sulfur Hexafluoride / Q000008:administration & dosage; D013536:Suture Techniques; D016896:Treatment Outcome; D014792:Visual Acuity; D014821:Vitrectomy / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods*
D013459:Sulfur Hexafluoride