Results and Complications of Idiopathic Macular Holes Operated With the 25-Gauge Transconjunctival Sutureless Vitrectomy

Abstract

Purpose:: to evaluate safety and efficacy of 25G transconjunctival vitrectomy in the management of idiopathic macular holes in the 6 month study.

Methods:: 26 patients (27 eyes) with idiopathic macular hole were included. Pre- and postoperative visual acuity ETDRS and full ophthalmological exam with evaluation of macular hole closure anatomical success in OCT were performed for all patients .Mean age of patients was 70 years (range 59-84),seventy percent of them were women. Fifty percent of macular holes were stage 3 and forty percent stage 4.All the patients have had a internal limiting membrane removal, with or without staining. Surgery was completed with intraocular tamponade with gas (C2F6 in 24/27 cases). All the patients were positioned face down for 7 to 10 days.

Results:: macular hole closure was achieved in 89%.The mean preoperative visual acuity was 1 logMAR (40/400) and postoperative 0,55 logMAR (20/63) with a follow-up of twelve months.The intraoperative complications were exceptional (a peripheral retinal break was noted during the surgery and was treated by transconjunctival cryotherapy). The postoperative complications were limited to two cases of hypotony below 6 mm Hg with no need of further treatment options. We did not notice choroidal detachment, neither important intraocular inflammation, nor retinal detachment or endophtalmitis.The only long term complication observed was a occasional progression of cataract during the follow-up period.

Conclusions:: the 25-gauge transconjunctival sutureless vitrectomy is a convenient, safe choice of surgery for idiopathic macular hole treatment and ameliorates the quality of life of the patient after surgery.

Clinical Trial:: Hospital XV-XX register

Keywords: vitreoretinal surgery • retina • vitreous