May 2008
Volume 49, Issue 13
Free
ARVO Annual Meeting Abstract  |   May 2008
25-Gauge Vitrectomy Using Sulfur Hexafluoride and No Prone Positioning for Repair of Macular Holes
Author Affiliations & Notes
  • A. C. Kopel
    Ophthalmology, Baylor College of Medicine, Houston, Texas
  • E. R. Holz
    Ophthalmology, Baylor College of Medicine, Houston, Texas
  • D. Kuhl
    Ophthalmology, Baylor College of Medicine, Houston, Texas
  • K. Pepple
    Ophthalmology, Baylor College of Medicine, Houston, Texas
  • J. Heffez
    Ophthalmology, Baylor College of Medicine, Houston, Texas
  • P. E. Carvounis
    Ophthalmology, Baylor College of Medicine, Houston, Texas
    Ophthalmology, Veterans Affairs, Houston, Texas
  • Footnotes
    Commercial Relationships  A.C. Kopel, None; E.R. Holz, None; D. Kuhl, None; K. Pepple, None; J. Heffez, None; P.E. Carvounis, None.
  • Footnotes
    Support  None.
Investigative Ophthalmology & Visual Science May 2008, Vol.49, 4677. doi:https://doi.org/
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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)

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Abstract

Purpose: : To report the outcomes of 25-gauge pars plana vitrectomy using sulfur hexafluoride and no prone positioning for repair of macular holes.

Methods: : 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.

Results: : 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.

Conclusions: : 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.

Keywords: macular holes • clinical (human) or epidemiologic studies: outcomes/complications • vitreoretinal surgery 
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