VITRECTOMY FOR IDIOPATHIC MACULAR HOLE

  • Mojca Globočnik-Petrovič Očesna klinika Klinični center Zaloška 29 1525 Ljubljana
Keywords: anteroposterior and tangential traction, hyaloid membrane, internal limiting membrane, maculorexis, postoperative complications

Abstract

Background. Idiopatic macular hole may result from tangential and anteroposterior traction along the vitreofoveal interface.

The visual loss in eyes with full thickness macular hole is tought to be caused by the absence of the neurosensory retina in the area of anatomical defect and by retinal detachment and oedema surrounding macular hole.

The goal of vitrectomy is to remove vitroretinal traction and to stimulate glial cell proliferation to reapproximate the edges of the hole.

We perform standard three-port pars plana vitrectomy. The posterior hyaloid is identified and elevated, dissection of internal limiting membrane is done. Long acting gass – 15% C3F8 or silicon oil is used for vitreal tamponade. Postoperative positioning is the rule.

Conclusion. Vitrectomy with removal of posterior hyaloid and internal limiting membrane enables macular hole closure and better visual function.

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References

Knapp. Ueber isolierte Zerreissungen der Aderhaut in Folge von Traumen auf dem Augopfel. Arch Augenheilkd 1869; 1: 6–29.

Kelly NE, Wendel RT. Vitreus surgery for idiopatic macular holes. Results of a pilot study. Arch Ophthalmol 1991; 109: 654–9.

Freeman WR, Azen SP, Kim JW et al. Vitrectomy for the treatment of full thickness stage 3 or 4 macular holes. Results of a multicentered randomised clinical trial. The vitrectomy for treatment of macular hole study group. Arch Ophthalmol 1997; 115: 11–21.

Gass JMD. Idiopatic senile macular hole: its early stages and patogenesis. Arch Ophthalmol 1988; 106: 629–39.

Gass JD. Reappraisal of biomicroscopic classification of stages of development of macular hole. Am J Ophthalmol 1995; 119: 752–9.

Gaudric A, Haouchine B, Massin P et al. Macular hole formation. Arch Ophthalmol 1999; 117: 744–51.

Margherio AR. Macular hole surgery in 2000. Current Opinion in Ophthalmology 2000; 11: 186–90.

Saiti Y, Hirata Y, Hayashi A et al. The visual performance and metamorphopsia of patients with macular holes. Arch Ophthalmol 2000; 118: 41–6.

Smiddy WE. Indications, surgical techniques and results of macular hole surgery. Ophthalmic Practice 1998; 165: 210–19.

Yoon HS, Brooks LH Jr., Capone A Jr. et al. Ultrastructural features of tissue removed during idiopathic macular hole surgery. Am J Ophthalmol 1996; 122: 67–75.

De Bustros S. Vitrectomy for prevention of macular holes: results of a randomized multicentered clinical trial. Ophthalmology 1994; 101: 1055– 60.

Poliner LS, Tornambe PE. Retinal pigment epitheliopathy after macular hole surgery. Ophthalmology 1992; 99: 1671–7.

Patel AC, Wedel RT. Vitrectomy for macular hole. Semin Ophthalmol 1994; 9: 47–55.

Smiddy WE, Pimentel S, Williams G. Macular hole surgery without adjunctive additives. Ophthalmic Surg 1997; 28: 713–7.

Ryan EH, Gilbert HD. Results of surgical treatment of recent-onset full thickness idiopathic macular holes. Arch Ophthalmol 1994; 112: 1545–53.

Syaarda RN, Glaser BM, Thompson JT et al. Effect of preoperative visual acuity in the treatment of macular holes with vitrectomy and TGF-B. Ophthalmology 1993; 100: Suppl: 73–3.

Tabandeh H, Chaudhry N, Smiddy WE. Retinal detachment associated with macular hole surgery. Invest Ophthalmol Vis Sci 1998; 30: 3174–4.

Banker A, Freeman W, Kim J, Munguia D, Azen S. Vision-treathing complications of surgery for full thickness macular holes. Ophthalmology 1997; 104: 1442–53.

Thompson JT, Glaser BM, Sjaarda RN, Murphy RP. Progression of nuclear sclerosis and long term visual results of vitrectomy with transforming growth factor b2 for macular holes. Am J Ophthalmol 1995; 119: 48–54.

Paques M, Massin O, Santiago PY et al. Visual field loss after vitrectomy for full thicknes macular holes. Am J Ophthalmol 1997; 124: 88–94.

Cullinane AB, Cleary PE. Prevention of visual field defects after macular hole surgery. Br J Ophthalmol 2000; 84: 372–7.

Charles CS. Retinal pigment epitelial abnormalities after macular hole surgery. Retina 1993; 13: 176–6.

Gass JMD. Discussion of retinal pigment epitheliopathy after macular hole surgery. Ophthalmology 1992; 99: 1678.

Tornambe PE, Poliner LS, Grote K. Macular hole surgery without face-down positioning. Retina 1997; 17: 179–85.

How to Cite
1.
Globočnik-Petrovič M. VITRECTOMY FOR IDIOPATHIC MACULAR HOLE. TEST ZdravVestn [Internet]. 1 [cited 5Aug.2024];71. Available from: http://vestnik-dev.szd.si/index.php/ZdravVest/article/view/1721
Section
Review