Short-Acting Gas Tamponade with Strict Face-Down Posturing for the Treatment of Idiopathic Macular Hole.

Abstract

PURPOSE:

A retrospective consecutive case series to evaluate the safety and efficacy of 25 gauge pars plana vitrectomy, ILM peeling, 20% SF6 gas tamponade and strict posturing for the treatment of idiopathic full-thickness macular holes.

METHODS:

We report the results of 106 consecutive eyes that underwent standard 25-gauge pars plana vitrectomy, brilliant peel-assisted internal limiting membrane peel, fluid:gas exchange with 20% SF6 and strict posturing for one week. All patients were followed up at one week, one month, three months, and nine months postoperatively. Biomicroscopy at day 1 and biomicroscopy and OCT at week 1, months 1, 3, and 9 were used to assess macular hole status postoperatively. Pre- and postoperative logMAR visual acuity was compared.

RESULTS:

The macular hole was closed in 102/106 eyes postoperatively (96.2%). Four eyes showed unclosed macular holes and underwent additional SF6 intravitreal injection and strict posturing for 10 days. All macular holes were eventually closed without the need of a second surgical procedure. Mean visual acuity improved from 0.63 logMAR preoperatively to 0.39 logMAR postoperatively. One case of retinal toxicity was reported due to accidental intravitreal injection of antibiotic.

CONCLUSIONS:

25-gauge vitrectomy, ILM peel, and short-acting gas tamponade are highly effective for the treatment of macular holes. Additional intravitreal gas injection followed by strict posturing seems to be a simple and effective treatment for unclosed holes.

• Authors: Stratos Gotzaridis, Efstathios Liazos, Petros Petrou, Ilias Georgalas
• Journal: Seminars in ophthalmology (Semin Ophthalmol) Vol. 32 Issue 5 Pg. 597-601 ( 2017) ISSN: 1744-5205 [Electronic] England
• PMID: 27367053 (Publication Type: Journal Article)

Chemical References

• Fluorocarbons

Topics

• Adult
• Aged
• Aged, 80 and over
• Endotamponade (methods)
• Epiretinal Membrane (surgery)
• Female
• Fluorocarbons (administration & dosage)
• Humans
• Male
• Middle Aged
• Patient Positioning (methods)
• Postoperative Period
• Retinal Perforations (surgery)
• Retrospective Studies
• Tomography, Optical Coherence
• Visual Acuity
• Vitrectomy (methods)