Abstract
Purpose::
In this interventional case series patients with persisting macular holes were retreated with the internal long term tamponade Densiron®.
Methods::
Ten patients with primary macular holes that were persisting after pars plana vitrectomy, peeling of the internal limiting membrane and internal gas tamponade with SF6 (sulphur hexafluoride) where retreated with the internal tamponade Densiron®. After 2-3 months the Densiron® was removed. Patients were assessed with a full ophthalmic examination including best-corrected visual acuity, slit lamp examination and optical coherence tomography (OCT) pre- and postoperatively with a follow up of 3-6 months. The least horizontal diameter of the macular hole and the retinal thickness were measured in OCT images.
Results::
Preoperatively, all patients depicted full thickness macular holes, with a mean size of 547,1 mm (+/- 153,8mm). Postoperatively, nine out of ten macular holes were closed. Two of the nine closed holes showed a residual retinal defect, but the retina remained attached. Mean visual acuity was 20/125 (0,8+/- 0,39 logMAR) preoperatively and 20/160 (0,9+/- 0,25 logMAR) postoperatively. Three patients showed a significant increase of 3 or more lines, only one patient showed a significant decrease of 3 lines. Mean retinal thickness was 237,6mm (+/- 37,2mm) preoperatively and 241,7mm (+/- 32,4mm) postoperatively.
Conclusions::
Anatomic closure of the macular hole after long term tamponade with Densiron® could be achieved in nine out of ten cases. Three of the nine patients with hole closure experienced a significant increase in visual acuity. In most cases, however, the functional results could not be improved.
Keywords: macular holes • vitreoretinal surgery • vitreous substitutes