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Ji Eun E. Lee, Hye Shin Jeon, Ik Soo Byon, Sung Who Park, Boo Sup Oum; Extramacular-hole Drainage Of Subretinal Fluid In Macular Hole Retinal Detachment. Invest. Ophthalmol. Vis. Sci. 2012;53(14):5794.
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Anatomical and functional results of macular hole (MH) retinal detachment has been reported inferior to those in simple retinal detachment or MH. Although drainage of subretinal fluid through MH during vitrectomy is the standard procedure, this maneuver may lead to damages of the surrounding macula and subsequent poor outcomes. We compared postoperative outcomes between in the eyes which underwent subretinal fluid drainage though MH and in the eyes though the other site than MH.
Retrospective analysis was performed with the medical records of the patients who underwent vitrectomy for MH retinal detachment between 2005 and 2011 and were followed up more than 4 months. Group E was defined as the eyes in which subretinal fluid was drained through extramacular-hole, and group M was defined as the eyes in which subretinal fluid was drained through MH. In the group E, if there is a pre-existing retinal break other than MH, subretinal fluid was drained through the break. Otherwise a retinotomy was made to drain subretinal fluid through. Pre- and postoperative best corrected visual acuity, primary success rate and macular hole closure in optical coherence tomography (OCT) were investigated.
Among 38 eyes, 13 eyes are in the group E and 25 eyes are in the group M. No significant difference was observed in baseline characteristics including axial length, staphyloma, and visual acuity between two groups. No significant difference was noted in primary success which was achieved in 12 eyes (92.3%) of the group E, and 16 eyes (64.0%) of the group M. OCT showed closed MH with no defect in 11 eyes (84.6%) of the group E and 8 eyes (32.0%) of the group M. Closure rate was significantly higher in the group E than the group M (p = 0.005). Visual acuity improved significantly in both groups (p = 0.008 in both groups), and the group E had significantly more improvement than the group M (p = 0.048).
Vitrectomy with subretinal fluid drainage through the other site than MH may avoid possible damages to the macula, and showed better results than the conventional procedure of drainage though macular hole in both anatomical and functional aspects.
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