May 2007
Volume 48, Issue 13
Free
ARVO Annual Meeting Abstract  |   May 2007
Vitrectomy Without Postoperative Posturing for Idiopathic Macular Holes
Author Affiliations & Notes
  • T. G. Heah
    Ophthalmology, Oxford Eye Hospital, Oxford, United Kingdom
  • A. Rubinstein
    Ophthalmology, Oxford Eye Hospital, Oxford, United Kingdom
  • A. Ang
    Ophthalmology, Oxford Eye Hospital, Oxford, United Kingdom
  • C. K. Patel
    Ophthalmology, Oxford Eye Hospital, Oxford, United Kingdom
  • Footnotes
    Commercial Relationships T.G. Heah, None; A. Rubinstein, None; A. Ang, None; C.K. Patel, None.
  • Footnotes
    Support None.
Investigative Ophthalmology & Visual Science May 2007, Vol.48, 4111. doi:
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    • Get Citation

      T. G. Heah, A. Rubinstein, A. Ang, C. K. Patel; Vitrectomy Without Postoperative Posturing for Idiopathic Macular Holes. Invest. Ophthalmol. Vis. Sci. 2007;48(13):4111.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose:: To determine the success of vitrectomy with ILM peeling and C3F8 tamponade for macular holes without the need of postoperative "face down" posturing.

Methods:: 24 eyes of 24 consecutive patients undergoing pars plana vitrectomy with ICG assisted ILM peeling and C3F8 tamponade without prone posturing were included in the study. All patients had follow-up on day-1, 2-week and 3-months postoperatively. Biomicroscopy and OCT were utilised to assess macular hole closure at 3 months postoperatively. Snellen visual acuity was compared pre and postoperatively.

Results:: 2/24 (8%) were stage II, 17/24 (71%) were stage III and 5/24 (21%) were stage IV macular holes. The mean duration of the holes was 8 months (range 4 - 12). 19/24 (79%) were phakic and 5/24 (21%) eyes were pseudophakic. 22/24 (91.6%) holes were closed at 3-month follow-up. In 2/24 (8.3%) eyes the holes remained opened. The two holes that failed to close were both stage IV macular holes. Pre-operative visual acuity ranged from 6/18 to 6/60 (mean 6/36). Post-operative visual acuity ranged from 6/9 to 6/60 (mean 6/18). Sixteen eyes had improvement of visual acuity of at least 2 lines on the snellen chart, 8 eyes had no improvement. No eyes had worse vision post-operatively. Five eyes had improvement of at least 3 snellen lines.

Conclusions:: 91.6% (22/24) of the holes were closed by 3 months, and this was confirmed by biomicroscopy and OCT. Macular hole surgery without "face down" posturing provides equally good anatomical and functional results as those with prone posturing. Combined phacovitrectomy is not essential to avoid prone posturing.

Keywords: macular holes • vitreoretinal surgery 
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