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Enrico Peiretti, Giulia Caminiti, Riccardo Saldì, Giovanni M. Satta; COMPARISON OF INVERTED FLAP AND SUBRETINAL ASPIRATION TECHNIQUE IN FULL THICKNESS MACULAR HOLE SURGERY. Invest. Ophthalmol. Vis. Sci. 2016;57(12):1100.
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© ARVO (1962-2015); The Authors (2016-present)
Comparison of surgical results in a consecutive series of patients with a macular hole stage IV documented with SD OCT , that were operated with two different techniques during a 25G pars plana vitrectomy (PPV).
20 eyes of 20 consecutive patients were treated and followed up for 6 months after surgery for a stage IV macular hole revealed on OCT scan. Patients were divided in 2 groups of 10 patients each. Both groups were operated under local anesthesia. After core vitrectomy, the posterior vitreous detachment was performed with the vitrectomy cutter in the suction mode if needed and ILM and any epiretinal membrane was peeled after dual blue coloration. In the first group, the subretinal remnant macular fluid was delicately aspirated with a 41G de Juan cannula after the air fluid exchange procedure and in the second group the technique of an inverted ILM flap was completed. At the end of the surgery, a mix of air and 20% of SF6 gas was injected into the eye. Patients were positioned face down for 5 days after surgery. Each patient was subjected to a complete ocular examination, at the baseline and at 1day, 3 weeks, 2 months and 3 months. BCVA and OCT were performed presurgically and at 1, 3 and 6 months.
100 % of the holes closed as documented by SD OCT analysis. The patients treated with subretinal fluid aspiration showed improvement of BCVA in 80% of the cases and 20% showed stabilization. The group of the inverted flap technique revealed that 30% of the eyes had a slightly improvement of BCVA, 50% had a stabilization and 30% showed a reduction of BCVA.
The two different surgical techniques showed similar results in term of closure rate of the stage IV macular holes, while BCVA outcomes seems to be better in the subretinal aspiration group.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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