INTERNAL ASPIRATION UNDER PERFLUOROCARBON LIQUID FOR THE MANAGEMENT OF LARGE MACULAR HOLES.
OBJECTIVE
To report the outcomes of pars plana vitrectomy with internal aspiration under perfluorocarbon liquid for large macular holes (MH).


METHODS
Retrospective consecutive case series of patients with large (>400 µm) MH. All treated were with pars plana vitrectomy, internal limiting membrane peeling, internal fluid aspiration under perfluorocarbon liquid, and gas/oil tamponade. Outcomes included closure rate and visual acuity at 6 months.


RESULTS
Twenty eyes of 20 patients were included. Mean age of patients was 67.6 ± 7.3 years. Mean MH size was 609.4 ± 154.7 μm. Mean symptoms duration was 9.05 ± 7.3 months. Unfavorable prognostic factors included chronic MHs (≥4 months) in 15 eyes (75%), refractory MH in 6 eyes (30%), and poor initial visual acuity (≤20/200 logarithm of minimal angle of resolution) in 18 eyes (90%). Gas tamponade was used in 18 eyes (90%). Nineteen MHs (95%) had closed after a single operation. Two (10.5%) had Type-II closure. Mean visual acuity improved significantly from 20/330 to 20/140 Snellen acuity (1.22 ± 0.31-0.85 ± 0.35 logarithm of minimal angle of resolution; P < 0.001). Fifteen eyes (75%) had visual acuity improvement of more than 0.2 logarithm of minimal angle of resolution. Thirteen eyes (65%) achieved visual acuity better than 20/200.


CONCLUSIONS
Pars plana vitrectomy combined with internal fluid aspiration under perfluorocarbon liquid is an effective and safe surgical technique for the management of large MH. This innovative technique offers improved closure rates and visual acuity results.
Department of Ophthalmology, Tel Aviv Sourasky Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Oded
O
Ohana
Adiel
A
Barak
Shulamit
S
Schwartz
D000368:Aged; D000369:Aged, 80 and over; D001485:Basement Membrane / Q000601:surgery; D058450:Endotamponade / Q000379:methods*; D005260:Female; D005466:Fluorocarbons / Q000494:pharmacology*; D005500:Follow-Up Studies; D006801:Humans; D008266:Macula Lutea / Q000473:pathology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D019152:Paracentesis / Q000379:methods*; D012167:Retinal Perforations / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013997:Time Factors; D014792:Visual Acuity; D014821:Vitrectomy / Q000379:methods*
D005466:Fluorocarbons