title: Repeat gas insufflation for successful closure of idiopathic macular hole following failed primary surgery.
abstract: A 65-year-old lady presented with decreased vision in left eye since seven months. Vision was 6/9 in right eye and 6/36 in left. Examination revealed idiopathic, full-thickness macular hole in left eye; confirmed by optical coherence tomography (OCT). Patient underwent phacoemulsification with intraocular lens (IOL) implantation, vitrectomy, internal limiting membrane (ILM) peeling and 14% C ₃ F ₈ gas injection. OCT repeated after six weeks revealed type II closure with cuff of subretinal fluid. Four weeks later, patient underwent fluid-gas exchange with 14% C ₃ F ₈ gas and postoperative positioning. OCT was repeated after two weeks, which showed complete closure of the macular hole. OCT can help in selection of eyes for re-surgery that stand a better chance for hole closure. Macular holes with cuff of subretinal fluid are probably more likely to close on re-surgery than those without. However, larger studies with longer follow-up are required to validate this finding.
authors.affiliation: Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralya, 18 College, Chennai, Tamil Nadu, India.
authors.forename: Pukhraj
authors.initials: P
authors.lastname: Rishi
authors.forename: Sumanth
authors.initials: S
authors.lastname: Reddy
authors.forename: Ekta
authors.initials: E
authors.lastname: Rishi
mesh_terms: D000368:Aged; D005260:Female; D005466:Fluorocarbons; D006801:Humans; D007327:Insufflation; D018918:Phacoemulsification / Q000009:adverse effects*; D011183:Postoperative Complications; D012167:Retinal Perforations / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D041623:Tomography, Optical Coherence; D014792:Visual Acuity
chemical_list: D005466:Fluorocarbons