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Fatimah Gilani, Andrei-Alexandru Szigiato, Mark Walsh, Rajeev H Muni; Subretinal BSS injection: A Technique for the Treatment of Chronic Persistent Macular Holes. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):5076.
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© ARVO (1962-2015); The Authors (2016-present)
To analyze the efficacy of subretinal injection of balanced salt solution for the treatment of chronic persistent macular holes refractory to treatment with one or more standard pars plana vitrectomies (PPV) with internal limiting membrane (ILM) peeling.
9 patients with chronic persistent macular holes were included in this retrospective consecutive case series conducted from 2011-2014. All patients had previously undergone one or more failed PPVs with ILM peeling. The patients subsequently underwent PPV with subretinal BSS injection.<br /> Visual acuity, ocular exam findings and OCT images were reviewed pre and post operatively to assess the anatomic and visual outcomes of this procedure.
Of the 9 patients who underwent the procedure, 7 had closure of their macular holes post-operatively which remained closed at the 6 month follow up (78%). The majority of patients reported a subjective visual improvement. A mean objective visual improvement of 0.296 Log MAR was seen between preoperative and 6 month postoperative assessments of all patients pre=1.558, post=1.262, p=0.046). Subgroup analysis of patients with successful closure revealed a 0.355 LogMAR improvement in visual acuity (pre=1.532, post=1.176, p=0.028). There were no intra-operative or post-operative complications.
PPV with subretinal BSS infusion appears to be a safe and effective treatment option for patients with persistent macular holes who have failed one or more prior vitrectomies with ILM peeling. Our results show improved anatomic and visual outcomes post-operatively that compare favorably to other case series describing various surgical treatments for these cases.
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