Abstract
Purpose :
To present an in-office method for closure of macular holes after initial failed vitrectomy surgery for macular hole repair.
Methods :
The charts of patients with initial failed idiopathic macular hole surgery who underwent focal laser and gas-fluid exchange on the same day in the office were reviewed. There were two patients who had failed macular hole surgery performed by the first author between 1997 and 2017. An additional patient who had a prior repaired retinal detachment and subsequent repaired proliferative vitreoretinopathy (PVR) with recurrent retinal detachment and epiretinal membrane (ERM) developed a late onset macular hole several years later and was treated with focal laser and gas-fluid exchange on the same day All three of these patients underwent focal laser followed by gas-fluid exchange. Focal laser was performed with a 50 micron spot size with 4 laser applications surrounding the margin of the macular hole. This was followed by fluid-gas exchange with 10% C3F8 gas and 1 week of face-down positioning.
Results :
The macular hole was successfully closed after focal laser and fluid-gas exchange in these eyes that had initial failure of macular hole closure after vitrectomy surgery and in the eye that developed a macular hole after surgery for retinal detachment ERM and PVR.
After one year of follow up, the corrected visual acuity was 20/70 in the first case, 20/32 in the second case and 20/40 in the third case.
Conclusions :
The method of focal laser around the margin of the macular hole with fluid-gas exchange in the office setting can provide a method of macular hole closure after initial failed macular hole vitrectomy surgery or in cases of macular hole development after epiretinal membrane vitrectomy surgery.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.