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satomi ohta, Takayuki Baba, Shuichi Yamamoto; Vitrectomy for macular hole secondary to blunt ocular trauma. Invest. Ophthalmol. Vis. Sci. 2013;54(15):5801.
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To determine the anatomical and functional outcomes after pars plana vitrectomy (PPV) for eyes with a macular hole secondary to blunt ocular trauma.
We reviewed the medical charts of 7 patients with a unilateral macular hole due to blunt trauma who underwent PPV at the Chiba University Hospital. The surgical procedures included peeling of the internal limiting membrane made visible by indocyanine green and brilliant blue G and intraocular tamponade with sulphur hexafluoride. The lens was removed and an intraocular lens implanted in one eye. The main outcome measures were the closure of macular hole confirmed by OCT and the best-corrected visual acuity (BCVA).
The average age of the patients ranged from 9-55 years (median, 19 years). The causes of the unilateral blunt trauma were the eye hit by a tennis racket, a bat, a fist, an air-bag, and fireworks. In addition, one eye developed a macular hole after laser in situ keratomileusis, and it was also studied. The time from the injury to PPV ranged from two to eleven months (median, 6 months), and the median follow-up time was 12 months (range: 3- 24 months). The macular hole of five patients was closed after the first operation and one patient required a second surgery. The decimal BCVA improved from 0.76±0.56 to 0.21±0.37 at the final visit (P=0.046). There were no intra- or postoperative complications. One patient had chorioretinal atrophy at the macular and underwent PPV two months after the injury. In this case, the macular hole was not closed after the initial surgery and the patient did not want further treatment. The BCVA in this case remained 20/200 at the final visit.
A macular hole after blunt trauma can be successfully closed by PPV in most cases. The absence of chorioretinal atrophy and the closure of macular hole appeared to be important for the recovery of the BCVA in cases of a traumatic macular hole.
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