Abstract
Purpose :
Evaluate the results of treatment of large macular holes with ILM peeling combined by a mechanically approximation of the borders technique, using a tano polisher and Sodium Hyaluronate viscoelastic (Healon 5®) as an adjunct.
Methods :
This case series includes subjects with full thickness idiopatic macular hole, measuring > 500 micrometers in the minimum diameter, with BCVA between 20/32 and counting fingers. Eyes with other fundus diseases, highly myopic eyes (above 8 diopters), eyes with non-controled glaucoma and subjects who underwent ocular surgery in the past three months were excluded from the study. Preoperative data obtained from each patient include: age, sex, duration of symptoms, and best corrected visual acuity, with ETDRS chart. After meeting the criteria, the subjects underwent surgery, all performed by the same surgeon. OCT and BCVA were performed in the day 0 of the preoperative, then monthly. All the OCT images were obtained with a Zeiss Cirrus HD-OCT device, by the same investigator.
Results :
CASE 1: Pre-op BCVA 20/400, diameter of 571mm, Post op BCVA 20/80
CASE 2: Pre-op BCVA CF 5m, diameter of 717mm, Post op BCVA 20/400
CASE 3: Pre-op BCVA 20/200, diameter of 817mm, Post op BCVA 20/60
CASE 4: Pre-op BCVA CF 2m, diameter of 562mm, Post op BCVA CF 5m
The OCT pointed full closure of the macular holes on all four patients. No sign of visco toxicity was observed. The patients presented improvements on visual acuity and also reported better visual quality after the procedure. We also analyzed those patients one year after the procedure and they maintained the BCVA and macular anatomy.
Conclusions :
This surgery model has demonstrated to be a viable option to address this
particular group of disease. Even though some similar approaches have been
described in the recent literature they differ in some key aspects as related to
our technique. Due to the excellent results emerged from our procedure, a large case series is warranted and already been planned. The goal is to achieve a good visual recovery in patients with large macular holes that were judged as untreatable.
This is a 2020 ARVO Annual Meeting abstract.