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A. C. Kopel, E. R. Holz, D. Kuhl, K. Pepple, J. Heffez, P. E. Carvounis; 25-Gauge Vitrectomy Using Sulfur Hexafluoride and No Prone Positioning for Repair of Macular Holes. Invest. Ophthalmol. Vis. Sci. 2008;49(13):4677. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To report the outcomes of 25-gauge pars plana vitrectomy using sulfur hexafluoride and no prone positioning for repair of macular holes.
Retrospective chart review of 44 consecutive patients who underwent pars plana vitrectomy with internal limiting membrane peel for repair of stage 2-4 macular holes using 20-30% sulfur hexafluoride. No patient maintained prone positioning or underwent gas augmentation postoperatively.
The closure rate was 88.6% (95% CI: 76%-95%). There were no differences in the closure rates of phakic compared to pseudophakic patients (21/23 versus 17/21, p=0.17, Fisher Exact test), or between Stage 2, 3 and 4 holes (12/13, 20/23 and 7/8 respectively, p=0.99, Fisher Exact test). In eyes successfully operated on, visual acuity improved from logMAR 0.61 (20/82) preoperatively to logMAR 0.483 (20/61) at 1 month (p=0.008) and to logMAR 0.396 (20/50, p=0.00002) at a mean of 10.8 months of final follow-up. Adverse effects noted were an elevation of the intraocular pressure over 30mmHg in 7/49 (14.3%) patients on the first post-operative day which persisted in 1 patient postoperatively and required filtering surgery, 2 postoperative retinal detachments (4.1%) and progression of cataract requiring cataract surgery in 7/23 (30.4%) phakic patients.
Macular hole closure rates similar to those achieved using pars plana vitrectomy with perfluoropropane and prone positioning can be achieved using sutureless 25-gauge vitrectomy with sulfur hexafluoride tamponade and no prone positioning in both phakic and pseudophakic patients.
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