title: Intraoperative changes in idiopathic macular holes by spectral-domain optical coherence tomography.
abstract: OBJECTIVE
  To examine anatomical changes in idiopathic macular holes during surgery using handheld spectral-domain optical coherence tomography (SD-OCT).
  
  
  METHODS
  Five eyes of 5 patients who underwent surgery for the repair of idiopathic macular holes were examined. The surgery included standard 25-gauge, 3-port pars plana vitrectomy, removal of the internal limiting membrane (ILM), fluid-air exchange, and 20% sulfur hexafluoride tamponade. Intraoperative SD-OCT images of the macular holes were obtained after ILM removal and under fluid-air exchange using a handheld SD-OCT. From SD-OCT images, the macular hole base diameter (MHBD) was measured and compared.
  
  
  RESULTS
  All macular holes were successfully closed after the primary surgery. The mean MHBD under fluid-air exchange was significantly smaller than the mean MHBD after ILM removal and the preoperative mean MHBD. In 1 eye with a stage 3 macular hole, SD-OCT images revealed that the inner edges of the macular hole touched each other under fluid-air exchange.
  
  
  CONCLUSIONS
  Fluid-air exchange significantly reduced MHBD during surgery to repair macular holes. Fluid-air exchange may be an important step for macular hole closure as it reduces the base diameter of the macular hole.
authors.affiliation: Department of Ophthalmology, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Hayashi
authors.forename: Takaaki
authors.initials: T
authors.lastname: Yagou
authors.forename: Tomoko
authors.initials: T
authors.lastname: Nakamura
authors.forename: Kazuya
authors.initials: K
authors.lastname: Fujita
authors.forename: Miyako
authors.initials: M
authors.lastname: Oka
authors.forename: Chiharu
authors.initials: C
authors.lastname: Fuchizawa