Indian Journal of Ophthalmology (Jan 2014)

Repeat gas insufflation for successful closure of idiopathic macular hole following failed primary surgery

  • Pukhraj Rishi,
  • Sumanth Reddy,
  • Ekta Rishi

DOI
https://doi.org/10.4103/0301-4738.116452
Journal volume & issue
Vol. 62, no. 3
pp. 363 – 365

Abstract

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A 65-year-old lady presented with decreased vision in left eye since seven months. Vision was 6/9 in right eye and 6/36 in left. Examination revealed idiopathic, full-thickness macular hole in left eye; confirmed by optical coherence tomography (OCT). Patient underwent phacoemulsification with intraocular lens (IOL) implantation, vitrectomy, internal limiting membrane (ILM) peeling and 14% C 3 F 8 gas injection. OCT repeated after six weeks revealed type II closure with cuff of subretinal fluid. Four weeks later, patient underwent fluid-gas exchange with 14% C 3 F 8 gas and postoperative positioning. OCT was repeated after two weeks, which showed complete closure of the macular hole. OCT can help in selection of eyes for re-surgery that stand a better chance for hole closure. Macular holes with cuff of subretinal fluid are probably more likely to close on re-surgery than those without. However, larger studies with longer follow-up are required to validate this finding.

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