Surgical Treatment of Macular Hole without Postoperative Vitreous Cavity Tamponade

Abstract

Purpose. To present the technique of macular hole surgery without vitreous cavity tamponade with gas or another vitreous substitute in post-op period. Patients and Methods. Frequency of the disease is 3 cases per 10,000, more often after 55 years — 3–3.3 cases per 1000, and the peak occurs at the age of 60 years and older. According to current data, the frequency of closure MH after vitreous surgery varies from 68 to 98 %. Sixteen eyes of 16 patients were operated on for full-thickness macular holes 100 to 932 (558.5 ± 50.9) microns in diameter. BCVA was 0.04 to 0.2 (0.09 ± 0.01). Follow-up period of the patients was 9 ± 6.3 weeks.Results. No intraoperative and postoperative complications were seen. In the result of surgery complete closure of the macular hole and anatomical restoration of the macula was achieved in 15 of 16 cases (92.8%). Postoperative BCVA was 0.2 to 0.6 (0.4 ± 0.04). A recurrence in one case was associated with a violation of operation technology when a partial mechanical displacement of the fibrin film with a cannula during PFCL exchange for air occurred. Conclusions. The suggested method of macular hole surgery without postoperative tamponade of the vitreous cavity with gas or another vitreous substitute may be used in routine clinical practice: Without face down positioning, reduced risk of cataract and increased IOP, air flight and climb to a height in the early post-op period.

Keywords

• macular hole
• platelet-rich blood plasma
• plugging substance
• vitrectomy