title: Macular hole in retinitis pigmentosa patients: microincision vitrectomy with polydimethylsiloxane as possible treatment.
abstract: OBJECTIVE
  To investigate long-term retinal changes after microincision pars plana vitrectomy surgery (MIVS) for macular hole (MH) in retinitis pigmentosa (RP) patients-retrospective and observational study.
  
  
  METHODS
  Three RP patients suffering from MH were evaluated by means of best corrected visual acuity, anterior and posterior binocular examination, spectralis high-resolution optical coherence tomography, MP-1 microperimetry (MP-1), and full-field electroretinogram (ERG), before MIVS and during the 36-month follow-up. Patients underwent simultaneous MIVS and microincision cataract surgery; IOL was positioned in capsular bag. Patients were hospitalised for 2 days after the surgery. Surgical procedure was performed according the following schedule: surgical removal of crystalline lens, MIVS with 23-gauge sutureless system trocars, core vitreous body removal, peeling of the inner limiting membrane, and balanced sterile saline solution-air-micro-structured polydimethylsiloxane (PDMS) exchange. PDMS tamponade, after 6 months starting from MIVS, was removed.
  
  
  RESULTS
  In all patients visual acuity increased after vitrectomy as a consequence of complete MH closure and restoration of retinal architecture. None of the patients developed ocular hypertension, or re-opening of MH during the 3-year follow-up. MP-1 bivariate contour ellipse area was reduced in its dimensions and improved in all patients demonstrating a better fixation.
  
  
  CONCLUSIONS
  MIVS could be an effective treatment in RP patients with MH if medical therapy is not applicable or not sufficient. Finally more studies will be needed to improve knowledge about this genetic disease.
authors.affiliation: Department of Ophthalmology, Polo Pontino, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy.
authors.forename: E M
authors.initials: EM
authors.lastname: Vingolo
authors.affiliation: Department of Ophthalmology, Polo Pontino, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Valente
authors.affiliation: Department of Ophthalmology, Polo Pontino, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Gerace
authors.affiliation: Department of Ophthalmology, Polo Pontino, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Spadea
authors.affiliation: Department of Sense Organs, Ocular Electrophysiology Center, Faculty of Medicine and Odontology, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Nebbioso
mesh_terms: D000328:Adult; D002387:Cataract Extraction; D004129:Dimethylpolysiloxanes / Q000008:administration & dosage*; D058450:Endotamponade; D005260:Female; D006801:Humans; D008297:Male; D008866:Microsurgery; D008875:Middle Aged; D012167:Retinal Perforations / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D012174:Retinitis Pigmentosa / Q000150:complications*; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D014792:Visual Acuity / Q000502:physiology; D058609:Visual Field Tests; D014794:Visual Fields; D014821:Vitrectomy
chemical_list: D004129:Dimethylpolysiloxanes; C013830:baysilon