Session Title: Free Paper Session 26: Vitreoretinal Surgery VI
Session Date/Time: Sunday 10/09/2017 | 10:00-11:30
Paper Time: 10:42
Venue: Room 116
First Author: : S.Gotzaridis GREECE
Co Author(s): : D. Portaliou V. Mela
To describe a new promising technique for closing operated full thickness macular holes (FTMH), that haven’t closed or re-opened ones, without taking the patient into the operating room and perform a new pars plana vitrectomy (PPV).
My Retina Athens eye centre, Athens, Greece
Six patients were included. All patients presented with visual acuity (VA) decrease, paramorphopsia or diagnosed FTMH condition. After Optical Coherence Tomography (OCT) scanning, a FTMH was confirmed. The patients’ condition was treated by a PPV procedure, where inner limiting membrane (ILM) was peeled and pure SF6 was injected as a tamponade. After a few months or weeks, a macular hole reopening was confirmed by OCT. SF6 and fluid exchange was performed according to a new technique. Surgical Technique: This surgical technique requires the patient to sit in front of the slit lamp, looking up. Three ml of pure SF6 are aspirated into a 5ml syringe. Using a 27 gauge insulin needle, an entrance to the centre of the vitreous cavity through the pars plana at 6 o’ clock is effectuated, with the needle pointing towards the optic nerve. Then, 1ml of intravitreal fluid is aspirated and 1ml of pure SF6 is injected. The procedure is repeated 2 more times, leaving into the eye 2.5ml of SF6 and an eye filled with 50% gas bubble. Patients were instructed to maintain a prone position for at least a week. After a week, OCT was repeated to confirm macular hole closure.
All cases had a successful macular hole closure after the procedure. Mean CDVA was improved from 0.98 ± 0.27 logMAR preoperatively, to 0.33 ± 0.24 logMAR at the last postoperative time visit (p=0.03). IOP had a statistically significant improvement at the 1st postoperative day at 21.57 ± 5.86 mmHg, whereas during the 1st postoperative week returned to normal values, at 16.0 ± 1.63 mmHg. No intra operative complications were reported in our case series.
A new surgical technique of SF6 injection for the management of re-opened macular holes after PPV procedure shows promising and long-lasting results.