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Revisiting transconjunctival sutureless 25 gauge vitrectomy for macular surgery
Author(s) -
GOTZARIDIS S,
LIAZOS ST,
MORPHIS G
Publication year - 2012
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.2012.3611.x
Subject(s) - medicine , tamponade , macular hole , vitrectomy , visual acuity , surgery , ophthalmology , intraocular pressure , retinal detachment , endophthalmitis , retinal
Purpose To report the results of 25g vitrectomy with ILM peeling, SF6 tamponade and strict face down posturing for the treatment of idiopathic macular holes. Methods This is a retrospective study of 106 eyes with idiopathic macular hole, treated with 25g PPV, brilliant peel assisted ILM peel , SF6 gas tamponade and face down posturing for 1 week. The patients were followed up at 1 day, 1 week, 1 month, 3 months and 9 months postoperatively clinically and with OCT. Preoperative and postoperative logMAR visual acuity was recorded Results 106 eyes were included in this study. 88 phakic (83%) and 18 pseudophakic (17%). 32 males (30%) and 74 females (70%). Mean age was 66.5 years. Mean preoperative visual acuity was 0.69 logMAR and improved at 0.39 logMAR at 9 months postoperatively.Anatomical macular hole closure rate was 100% (106/106). 102/106 patients (96%) had anatomical closure of the hole after the 1st operation. 4/106 patients had an open hole noticed at 1 week and received an additional SF6 injection at the office and strict face down posturing for another week. 4/4 patients had the hole closed at month 1. Postoperative complications included a case of macular toxicity due to accidental intravitreal leak through the sutureless port of gentamycin which was injected subconjunctivaly at the end of surgery. Early postoperative raised intraocular pressure was noticed in 6 patients (5.6%) . No retinal detachment and no case of endophthalmitis was noticed. Conclusion 25g PPV, ILM peeling, SF6 gas tamponade and posturing is a safe and effective technique for the treatment of idiopathic macular holes. Additional gas injection combined with extended strict posturing can increase the anatomical closure rate without the need of additional surgery.