Purchase this article with an account.
Eli Levitt, Gina Yu, Aria Bassiri, Jorge G Arroyo; Ocular Coherence Tomographic Imaging in Patients with Recurrent Full Thickness Macular Holes. Invest. Ophthalmol. Vis. Sci. 2016;57(12):4254.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To evaluate the efficacy of pars plana revision vitrectomy, ILM peeling, and long-term internal tamponade for recurrent full thickness macular holes (FTMH). The success rate of macular hole surgery in patients with a primary idiopathic macular holes ranges from 90-95%. Our study investigates the anatomic closure rate and the anatomic changes in macular holes, as visualized by ocular coherence tomography scanning, that occur in treatment of recurrent FTMHs.
This single-site, single-surgeon, retrospective study analyzed 12 medical records (13 eyes) of patients who received two surgeries at the Beth Israel Deaconess Medical Center for persistent macular holes (2004-2013). Persistent was defined as no closure (n=2 eyes) or reopening (n=11) at least 1 month following surgery. Patients were treated with a three-port, pars plana vitrectomy (PPV), with or without internal limiting and/or epiretinal membrane peeling, and fluid gas exchange of SF6 (n=2) or C3F8 (n=1), or silicone oil (n=10). The primary outcome measure was complete FTMH closure as established by ocular coherence tomography (OCT) within 1 month of the second procedure. Visual acuity was also documented pre- and post-reoperation. Any complications resulting from the second surgery and underlying eye conditions prior to receiving treatment were documented
Ten out of 13 (76.9%) total eyes had closed FTMH 1 month following the second procedure, 1 out of 2 (50%) with an unclosed FTMH and 9 out of 11 with a reopened FTMH (90.1%). Six out of 10 patients (60%) in which VA was documented had improvement of at least 3 lines following surgery (1 week post-op), 2 (20%) remained the same, and 2 (20%) worsened.
We find that second PPV/MP in patients with persistent FTMH has high efficacy, though not as high as in primary macular hole surgery. Future larger studies are needed to validate these results.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
This PDF is available to Subscribers Only