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Vitrectomy without postoperative posturing for idiopathic macular holes
Author(s) -
Rubinstein Adrian,
Ang Alan,
Patel Chetan Kantibhai
Publication year - 2007
Publication title -
clinical and experimental ophthalmology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.3
H-Index - 74
eISSN - 1442-9071
pISSN - 1442-6404
DOI - 10.1111/j.1442-9071.2007.01532.x
Subject(s) - medicine , vitrectomy , macular hole , tamponade , pars plana , visual acuity , ophthalmology , snellen chart , surgery , vitreoretinal surgery
A bstract Purpose: To determine the success of vitrectomy with ILM peeling and C 3 F 8 tamponade for macular holes without the need for postoperative face‐down posturing. Methods: Twenty‐four eyes of 24 consecutive patients undergoing pars plana vitrectomy with indocyanine green‐assisted ILM peeling and C 3 F 8 tamponade without prone posturing were included in the study. All patients had follow up on 1 day, 2 weeks and 3 months postoperatively. Biomicroscopy and optical coherence tomography were used to assess macular hole closure at 3 months postoperatively. Snellen visual acuity was compared pre‐ and postoperatively. Results: Of the 24 eyes recruited, two (8%) had stage II, 17 (71%) had stage III and five (21%) had stage IV macular holes. Nineteen (79%) eyes were phakic and five (21%) eyes were pseudophakic at the time of surgery. The macular holes had been present for an average of 7.5 months (range 3–18 months). At 3‐month follow up, 22/24 (91.6%) holes were closed. Both of the two holes that failed to close were stage IV macular holes. Preoperative visual acuity ranged from 6/18 to 6/60 (mean 6/36). Postoperative visual acuity ranged from 6/9 to 6/60 (mean 6/18). Eighteen eyes had improvement of visual acuity of at least one line on the Snellen chart, six eyes had no improvement. No eyes had worse vision postoperatively. Conclusion: Macular hole surgery without face‐down posturing provides anatomical and functional results comparable to those with prone posturing. Combined phacovitrectomy is not essential to avoid prone posturing.