Abstract
Purpose :
To evaluate the long-term outcome of vitrectomy with internal limiting membrane (ILM) peeling and SF6 gas tamponade for macular holes in patients without postoperative face-down positioning.
Methods :
Forty-three eyes of 42 patients undergoing pars plana vitrectomy with indocyanine green-assisted ILM peeling and 20% SF6 gas tamponade without postoperative face-down positioning were included in this study. Biomicroscopy and optical coherence tomography were used to assess macular hole closure. Pre- and postoperative visual acuity (VA) were compared. Cases with more than 5 years follow-up were included.
Results :
Among the 43 eyes, 10 (23.3%) had stage 2, 24 (55.8%) had stage 3, and 9 (20.9%) had stage 4 macular holes. Mean macular hole size was 0.30 disc diameters. All eyes were phakic. All macular holes initially closed, and no eyes showed reopening. The postoperative mean follow up period was 8.26 years. Preoperative mean VA (logMAR) was 0.59, and mean VA significantly improved to 0.40 at 1 month, 0.28 at 3 months, 0.23 at 6 months, 0.16 at 1 year, 0.10 at 2 years, 0.10 at 3 years, 0.07 at 4 years, 0.07 at 5 years, and 0.07 at the final visit after surgery (p＜0.001, repeated measures analysis of variance).
Conclusions :
Macular hole surgery with ILM removal and SF6 gas tamponade without postoperative face-down positioning is a potentially useful option for patients for whom postoperative face-down positioning is difficult. In addition, postoperative care without face-down positioning is easier and more convenient. The present findings indicate that improved VA can be expected for up to 4 years after surgery.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.