Combined macular detachment and macular massage in large macular hole

Abstract

Background Over the past two decades, the surgical treatment of full-thickness macular holes (MHs) has advanced significantly, with current hole closure rate increasing more than 95%. Aim To assess the visual and anatomical outcomes of combined macular detachment and macular massage techniques for large MHs. Patients and methods The current work involved 12 eyes of 12 patients with large full-thickness idiopathic or traumatic MH. All participants were subjected to full ophthalmic assessment and measurement of best-correctable Snellen visual acuity, intraocular pressure, fundus photograph, and spectral-domain ocular coherence tomography at preoperative and postoperative periods. All surgeries were done by two surgeons and followed up at least 6 months. Results Outcomes of our techniques showed that there were nine (75%) patients with complete closure, whereas other three (25%) patients with a partial closure. Improvement of vision occurred in eight (66.7%) patients, and one patient showed a retinal tear temporal to macula as an intraoperative complication. Mean postoperative macular thickness in these closed MHs was 166 ± 54 μm. In the nonclosed MHs, the mean diameter of the aperture was 611 ± 218 and the mean diameter of the base was 726 ± 265 μm. Moreover, ocular coherence tomography showed that there was retinal pigment epitheliopathy with different degrees in almost our cases. Conclusion Combination of macular detachment and macular massage techniques showed a satisfactory anatomical and functional outcome in cases of large MHs.

Keywords

• large macular hole
• macular detachment
• macular massage