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C. Pruente, H.L. Kain, M. Martin; Early foveal recovery after macular hole surgery with air tamponade . Invest. Ophthalmol. Vis. Sci. 2004;45(13):1983.
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Purpose:The aim of this study was the evaluation of functional and morphological recovery after macular hole surgery using air tamponade. Methods:Pars plana core vitrectomy with ILM–peeling and air tamponade was performed in 20 consecutive patients with macular hole, stage II–IV. After surgery the patients were instructed to remain in facedown position for 3 days with free positioning for meals, personal hygiene and during night. Visual acuity, photo documentation and optical coherence tomography (OCT) were used as follow–up parameters. Results:4 days after surgery the rims of the macular hole could not be differentiated by biomicroscopy in 11 eyes (55%). Furthermore, OCT examination showed a normalized, continuing retinal structure in the fovea in 19 eyes at this early follow–up examination. The overall success rate after 1 year was 95%. In one case, where OCT did not confirm a continuous retinal structure in the fovea at the 4th day, biomicroscopy revealed reopening of the macular hole after 3 month. 1 week after surgery improvement of visual acuity of one or more lines was found in 11 eyes. Visual acuity of 20/40 or better was found in 16 cases (80%) at the one year visit. Progressive cataract could be observed in 66% of the eyes. Conclusions:Our results suggest, that morphological and functional recovery of macular structure after successful macular hole surgery already occurs during the first postsurgical days. Therefore, air tamponade might be sufficient in these cases.
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