SF6 injection for closing macular holes or reopened ones: A new technique

Session Details

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                          

Abstract Details

Purpose:

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).

Setting:

My Retina Athens eye centre, Athens, Greece

Methods:

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.

Results:

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.

Conclusions:

A new surgical technique of SF6 injection for the management of re-opened macular holes after PPV procedure shows promising and long-lasting results.

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