अमूर्त

Macular hole surgery with silicone oil as a tamponade

Carl-Ludwig Schonfeld, Linda Maren Meyer, Thomas Klink, Christos Haritoglou

Purpose: Pars plana vitrectomy (PPV) with gas endotamponade is the gold standard for the surgical treatment of macular holes. An alternative may be an endotamponade with silicone oil (SiO) which does not require postoperative prone posture.

Methods: 56 patients/57 eyes with macular holes (diameter 94-932 μm) underwent a primary PPV with SiO endotamponade or a secondary SiO after failure of a previous intervention. Endpoints were closure of macular hole and best corrected visual acuity (BCVA) measured by means of logMAR.

Results: Closure of macular holes was achieved in 50 eyes (87.7%), 90.0% in primary and 82.4% in secondary SiO. LogMAR improved in 82.5% of primary and 76.5% of secondary SiO. Mean postoperative logMAR decreased significantly both in the whole group and in the two subgroups. In total, the mean factor of BCVA improvement was 2.63 ± 2.57, and it did not differ significantly between primary and secondary SiO (3.09 ± 2.51 vs. 1.82 ± 2.40).

Conclusion: PPV with SiO endotamponade for the treatment of macular holes achieves very good results with regard to the anatomical closure and VA. SiO is not only an alternative for elderly or comorbid patients where postoperative prone posture is impossible, but also in recurrent cases or large macular holes avoiding manipulation under the retina.