Vitrectomy for chronic macular hole
Abstract
Background: Vitrectomy for idiopathic macular hole has a good prognosis but it depends on duration of the condition. Anatomic and functional results of operation are less good if macular hole has persisted for more than one year. The aim of our study was to present success of vitrectomy for chronic macular hole.
Methods: Data of 74 eyes with idiopathic macular hole operated between June 2000 and September 2003 were retrospectively reviewed. Duration of macular hole, preoperative visual acuity, postoperative visual acuity and hole closure were analysed data. Eyes were divided into two groups with respect to duration of macular hole (less or more than one year). The two groups were compared regarding functional and anatomic success of operation.
Results: Postoperative visual acuity improved in 65.5% of eyes in the chronic macular hole group. Improvement of visual acuity was noticed in 88.6% of eyes with acute macular hole. Anatomic success was evident in 72.4% of eyes with chronic macular hole and in 97.2% in the acute macular hole group.
Conclusions: Vitrectomy with intraocular gas tamponade is an effective mode of treatment for chronic macular holes, although the overall success is not as good as for acute macular holes.
Downloads
References
Ho A, Guyer D, Fine S. Macular hole. Surv Ophthalmol 1998; 42: 393–416.
McDonnell PJ, Fine SL, Hillis AI. Clinical features of idiopathic macular cysts and holes. Am J Ophthalmol 1982; 93: 777–86.
Ezra E, Wells JA, Gray RH, Kinsella FM, Orr GM, Grego J, et al. Incidence of idiopathic full-thickness macular holes in fellow eyes: a 5-year prospective natural history study. Ophthalmology 1998; 105: 353–9.
Chew EY, Sperduto RD, Hiller R, Nowroozi L, Siegel D, Yanuzzi LA, et al. Clinical course of macular holes: the Eye Disease Case-Control Study. Arch Ophthalmol 1999; 117: 242–6.
Gaudric A, Haouchine B, Massin P, Paques M, Blain P, Erginay A. Macular hole formation: new data provide by optic coherence tomography. Arch Ophthalmol 1999; 117: 744–51.
Gordon LW, Glaser BM, Ie D, Thompson JT, Sjaarda RN. Full-thickness macular hole formation in eyes with a pre-existing complete posterior vitreous detachment. Ophthalmology 1995; 102: 1702–5.
Gass JDM. Lamellar macular hole: a complication of cystoid macular edema after cataract extraction: a clinicopathologic case report. Trans Am Ophthalmol Soc 1976; 73: 230–50.
Guyer DR, Green WR, de Bustros S, Fine SL. Histopathologic features of idiopathic macular holes and cysts. Ophthalmology 1990; 97: 1045–51.
Martinez J, Smiddy WE, Kim J, Gass JD. Differentiating macular holes from macular pseudoholes. Am J Ophthalmol 1994; 117: 762–7.
Kelly NE, Wendel RT. Vitreous surgery for idiopathic macular holes: results of a pilot study. Arch Ophthalmol 1991; 109: 654–9.
Da Mata AP, Burk SE, Riemann CD, Rosa RH jr, Snyder ME, Petersen MR, Foster RE. Indocyanin green-assisted peeling of the retinal internal membrane during vitrectomy surgery for macular hole repair. Ophthalmology 2001; 108: 1187–92.
Park DW, Sipperley JO, Sneed SR, Dugel PU, Jacobsen J. Macular hole surgery with internal-limiting membrane peeling and intravitreous air. Ophthalmology 1999; 106: 1392–8.
Mester V, Kuhn F. Internal limiting membrane removal in the management of full-thickness macular holes. Am J Ophthalmol 2000; 129: 769–77.
Ryan EHJ, Gilbert HD. Results of surgical treatment of recent-onset fullthickness idiopathic macular holes. Arch Ophthalmol 1994; 112: 1545–53.
Smiddy WE, Pimentel S, Williams GA. Macular hole surgery without using adjunctive additives. Ophthalmic Surg Lasers 1997; 28: 713–7.
Hikichi T, Trempe CL. Resolution of an absolute scotoma after spontaneous disappearance of idiopathic full-thickness macular hole. Am J Ophthalmol 1994; 118: 121–2.
Roth DB, Smiddy WE, Feuer W. Vitreous surgery for chronic macular holes. Ophthalmology 1997; 104: 2047–52.
Scott RA, Ezra E, West JF, Gregor ZJ. Visual and anatomical results of surgery for long standing macular holes. Br J Ophthalmol 2000; 84: 150–3.
Stec LA, Ross RD, Williams GA, Trese MT, Margherio RR, Cox MS Jr. Vitrectomy for chronic macular holes. Retina 2004; 24: 341–7.
Thompson JT, Sjaarda RN, Lansing MB. The results of vitreous surgery for chronic macular holes. Retina 1997; 17: 493–501.
Funata M, Wendel RT, de la Cruz Z, Green WR. Clinicopathologic study of bilateral macular holes treated with pars plana vitrectomy and gas tamponade. Retina 1992; 12: 289–98.
Smiddy WE, Flynn HW. Pathogenesis of macular holes and therapeutic implications. Am J Ophthalmol 2004; 137: 525–37
Ip MS, Baker BJ, Duker JS, Reichel E, Baumal CR, Gangnon R, Puliafito CA. Anatomical outcomes of surgery for idiopathic macular hole as determined by optical coherence tomography. Arch Ophthalmol 2002; 120: 29–35.
Kwok AK, Lai TY, Man-Chan W, Woo DC. Indocyanine green assisted retinal internal limiting membrane removal in stage 3 or 4 macular hole surgery. Br J Ophthalmol 2003; 87: 71–4.
Kwok AK, Lai TY. Internal limiting membrane removal in macular hole surgery for severely myopic eyes: a case-control study. Br J Ophthalmol 2003; 87: 885–9.
Eckardt U, Eckardt C. Binocular vision in idiopathic macular foramen. Preand postoperative findings. Ophthalmologe 1995; 92: 626–30.
Bron AJ, Tripathi RC, Tripathi BJ. Wolff’s anatomy of the eye and orbit. 8th ed. Spain: Chapman and Hall Medical; 1997.
Yooh HS, Brooks HL Jr, Capone A Jr, L’Hernault NL, Grossniklaus HE. Ultrastructural features of tissue removed during idiopathic macular hole surgery. Am J Ophthalmol 1996; 122: 67–75.
Smiddy WE, Flynn HW, Cordahi G. Internal limiting membrane peeling in macular hole surgery. Ophthalmology 2001; 108: 1471–8.
Brooks HL. Macular hole surgery with and without internal limiting membrane peeling. Ophthalmology 2000; 107: 1939–49.
Terasaki H, Miyake Y, Nomura R, Piao CH, Hori K, Niwa T, Kondo M. Focal macular ERGs in eyes after removal of macular ILM during macular hole surgery. Invest Ophthalmol Vis Sci 2001; 42: 229–34.
Gandorfer A, Haritoglou C, Gass CA, Ulbig MW, Kampik A. Indocyanine green-assisted peeling of the internal limiting membrane may cause retinal damage. Am J Ophthalmol 2001; 132: 431–3.
Sippy BD, Engelbrecht NE, Hubbard GB, Moriarty SE, Jiang S, Aaberg TM Jr, et al. Indocyanine green effect on cultured human retinal pigment epithelial cells: implication for macular hole surgery. Am J Ophthalmol 2001; 132: 433–5.
Haritoglou C, Gass CA, Schaumberger M, Ehrt O, Gandorfer A, Kampik A. Macular changes after peeling of the internal limiting membrane in macular hole surgery. Am J Ophthalmol 2001; 132: 363–8.
Haritoglou C, Gandorfer A, Gass CA, Schaumberger M, Ulbig MW, Kampik A. Indocyanine green-assisted peeling of the internal limiting membrane in macular hole surgery affects visual outcome: a clinicopathological correlation. Am J Ophthalmol 2002; 134: 836–41.
Yam HF, Kwok AK, Chan KP, Lai TY, Chu KY, Lam DS, Pang CP. The effects of indocyanine green and illumination on gene expression in human retinal pigment epithelial cells. Invest Ophthalmol Vis Sci 2003; 44; 370–7.
Stalmans P, Van Aken EH, Veckeneer M, Feron EJ, Stalmans I. Toxic effect of indocyanine green on retinal pigment epithelium related to osmotic effects of the solvent. Am J Ophthalmol 2002; 134: 282–5.
Weinberger AW, Schlossmacher B, Dahlke C, Hermel M, Kirchhof B, Schrage NF. Indocyanine-green-assisted internal limiting membrane peeling in macular hole surgery: a follow-up study. Graef Arch Clin Exp Ophthalmol. 2002; 240: 913–7.
Ellis JD, Malik TY, Taubert MA, Barr A, Baines PS. Surgery for full-thickness macular holes with short duration prone posturing, result of a pilot study. Eye 2000; 14: 301–7.
Minihan M, Goggin M, Clearly PE. Surgical management of macular holes; results using gas tamponade alone, or in combination with autologus platelet concentrate, or transforming growth factor 2. Br J Ophthalmol 1997; 81: 1073–9.
Tornambe PE, Poliner L, Grote K. Macular hole surgery without face-down positioning. Retina 1997; 17: 179–85.
Simcock PR, Scalia S. Phacovitrectomy without prone posture for full thickness macular holes. Br J Ophthalmol 2001; 85: 1316–9.
Thompson JT. The role of patient age and intraocular gas use in cataract progression after vitrectomy for macular holes and epiretinal membranes. Am J Ophthalmol 2004; 137: 250–7.
Freeman WR, Azen SP, Kim JW, et al. Vitrectomy for the treatment of fullthickness stage 3 or 4 macular holes. Arch Ophthalmol 1997; 115: 11–21.
The Author transfers to the Publisher (Zdravniški vestnik/Slovenian Medical Journal) all economic copyrights following form Article 22 of the Slovene Copyright and Related Rights Act (ZASP), including the right of reproduction, the right of distribution, the rental right, the right of public performance, the right of public transmission, the right of public communication by means of phonograms and videograms, the right of public presentation, the right of broadcasting, the right of rebroadcasting, the right of secondary broadcasting, the right of communication to the public, the right of transformation, the right of audiovisual adaptation and all other rights of the author according to ZASP.
The aforementioned rights are transferred non-exclusively, for an unlimited number of editions, for the term of the statutory
The Author can make use of his work himself or transfer subjective rights to others only after 3 months from date of first publishing in the journal Zdravniški vestnik/Slovenian Medical Journal.
The Publisher (Zdravniški vestnik/Slovenian Medical Journal) has the right to transfer the rights, acquired parties without explicit consent of the Author.
The Author consents that the Article be published under the Creative Commons BY-NC 4.0 (attribution-non-commercial) or comparable licence.
