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J. C. Chang, S. M. Hariprasad, J. Benevento, W. F. Mieler; Efficacy of 25-Gauge Vitrectomy, ILM Peeling, and Gas Fluid Exchange for Closing Chronic Macular Holes. Invest. Ophthalmol. Vis. Sci. 2007;48(13):2220.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the outcomes of 25-gauge vitrectomy surgery for chronic macular holes (MH)
A retrospective review of 12 patients (12 eyes) with chronic MH who underwent 25-gauge pars plana vitrectomy, internal limiting membrane (ILM) peeling with kenalog enhancement, and gas-fluid exchange using 14% C3F8. Closure rate, visual outcomes, and OCT findings were assessed.
All patients had stage 3 or 4 chronic MH (mean= 5.5 yrs; range= 1-20 years). The mean age of patients was 70.3 years (range= 58-83 years). Preoperative visual acuity ranged from 20/70 to CF. Nine of 12 (75%) MH were closed at the most recent follow up visit (mean= 5.3 months; range= 1.5 to 9 months). Postoperative visual acuity ranged from 20/40 to 20/400. Eight eyes (67%) improved vision by halving the visual angle. Five eyes (42%) achieved vision of 20/60 or better. Seven eyes (58%) achieved vision of 20/80 or better. Two (17%) eyes had unchanged vision. No eye in this series experienced vision loss. Unique OCT findings after chronic MH repair will be presented.
A large number of chronic MH can be successfully closed with visual improvement using 25-gauge vitrectomy with ILM peeling and gas-fluid exchange. OCT findings seen with closed chronic MH may offer insights as to why these eyes don’t recover vision to as great a degree as after the closure of acute MH.
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