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Calvin Einar Mein, Clement K Chan; Pneumatic Maculopexy: A Novel Approach for Treatment of Symptomatic Vitreomacular Traction. Invest. Ophthalmol. Vis. Sci. 2014;55(13):300.
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To demonstrate the efficacy of intraocular gas injection and limited face-down positioning for treatment of symptomatic vitreomacular traction(VMT)
A retrospective case review was conducted on 9 eyes with vitreomacular traction syndrome treated with intraocular gas injection and limited face down positioning. All eyes were treated with in-office injection of 0.3 to 0.4ml of C3F8 gas and instructed to position face down part time for at least one or two days.
Nine cases were reviewed. All eyes had VMT. One eye had a Stage 2 macular hole. Five eyes with vitreomacular traction alone and no macular hole had complete release of the VMT within one month after intraocular gas injection alone. One eye with a Stage 2 macular hole was treated with 0.3 ml of C8F8 and limited face down position. Complete closure of the macular hole was achieved by week four. One eye with broad VMT was treated with ocriplasmin with incomplete release of the VMT. Intraocular gas injection of 0.3ml of C3F8 resulted in release of the central VMT. One eye with VMT initially treated with ocriplasmin developed a full thickness macular hole within 24 hours. Injection of 0.3 ml of C8F8 gas and face down positioning resulted in complete closure of the macular hole within four days. One eye with VMT was initially treated with Ocriplasmin but the VMT did not resolve. An intraocular gas injection was performed. The patient developed a retinal detachment that was successfully repaired with vitrectomy and gas tamponade.
Intraocular gas injection alone in the office setting followed by limited face-down positioning appears to be a viable novel alternative for treatment of symptomatic VMT.
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