Intravitreal expansile gas in the treatment of early macular hole: reappraisal.
OBJECTIVE
To study the effects of intravitreal injection (IVI) of expansile gas for early macular holes (EMH).


METHODS
Prospective interventional case series. Twelve eyes of 12 patients with EMH (stage 2) underwent IVI of perfluoropropane 0.2 ml followed by 5 days' facedown positioning.


RESULTS
Six cases (50%) achieved vitreous-macula separation. Three cases (25%) had hole closure with vision improvement; one of them developed rhegmatogenous retinal detachment (RRD) and hole re-opening. Another case with persistent hole also developed RRD. Seven of the 9 cases without hole closure and the one where the hole re-opened had vitrectomy, all resulting in hole closure and vision improvement. Duration of symptoms had borderline significance for hole closure (p = 0.11) and subsequent visual improvement (p = 0.03).


CONCLUSIONS
With its low success rate, IVI of gas may not be a good option for EMH. Complications include retinal detachment. The procedure seems to not affect hole closure with subsequent vitrectomy.
Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan, ROC.
Ta-Ching
TC
Chen
Chang-Hao
CH
Yang
Chung-May
CM
Yang
D000368:Aged; D058450:Endotamponade; D005260:Female; D005466:Fluorocarbons / Q000008:administration & dosage*; D005500:Follow-Up Studies; D006801:Humans; D058449:Intravitreal Injections; D008297:Male; D008875:Middle Aged; D016684:Prone Position; D011446:Prospective Studies; D012167:Retinal Perforations / Q000145:classification / Q000175:diagnosis / Q000601:surgery*; D013997:Time Factors; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology; D014822:Vitreous Body / Q000187:drug effects
D005466:Fluorocarbons; C042852:perflutren