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S.S. Couvillion, C.W. Eifrig, W.E. Smiddy; Vitrectomy and Silicon Oil Tamponade for Macular Holes . Invest. Ophthalmol. Vis. Sci. 2003;44(13):3043.
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Abstract: : Purpose: To evaluate rate of hole closure and visual outcomes in macular hole surgery using silicon oil tamponade. Methods: Retrospective chart review of patients who had undergone macular hole surgery using silicon oil for stage II, III or IV macular holes. Patients were unwilling to position secondary to medical contraindications or required air travel that precluded the use of perfluoropropane gas. Results: 14 eyes of 13 patients had pars plana vitrectomy with detachment of the posterior cortical vitreous and injection of silicon oil. The average macular hole duration prior to surgery was 3 months and average time to removal of silicon oil after vitrectomy was 7 months. The average follow-up after initial macular hole surgery was 10 months. Internal limiting membrane peel was performed in 12 eyes. Anatomic closure occurred in 11 eyes (78.5 %). Median visual acuity prior to surgery was 20/400. Final visual acuity was 20/400 or worse in 7 (50%) eyes with only one eye achieving a final vision of 20/70 or better. Patients in this series had underlying retinal pathology including previous macular hole surgery in 2 eyes and retinal detachment in 6 eyes. No post-operative complications occurred and one patient had a retinal detachment identified intraoperatively. Conclusions: The anatomic closure rate of 78.5 % is slightly lower than previously published case series using silicon oil tamponade or perfluoropropane gas and visual acuity outcomes are less favorable in comparison with previous reports. Macular hole surgery using silicon oil tamponade should be reserved for those patients unable to maintain face down positioning, or who have air-travel requirements.
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