Posters

Macular hole vitreoretinal interface: Surgical and pathophysiological correlations

Poster Details

First Author: J.Gonzalez Cortes MEXICO

Co Author(s):    A. Gonzalez Martinez   Y. Bages Rousselon   H. Trevino Rodriguez   M. de Alba Castilla   J. Davila Villareal   C. Azuara Azuara              

Abstract Details



Purpose:

The vitreous is a complex structure whose composition changes with age. Anomalous adhesions between the posterior vitreous and the retinal surface cause numerous complications such as vitreomacular traction syndrome, and vitreoschisis with subsequent macular hole (MH) and epirretinal membrane (ERM) formation. The purpose of this poster is to demonstrate the usefulness of markers and dyes in the identification of the vitreomacular interface during MH surgery.

Setting:

Departamento de oftalmologĂ­a. Hospital Universitario. Facultad de Medicina. UANL.

Methods:

Pars plana vitrectomy was performed using preservative-free triamcinolone acetonide as a vitreomacular interface marker, and brilliant blue.

Results:

We found different forms of interface disorder manifestations: MH without residual hypocellular posterior cortex (RHPC) neither ERM. MH with ERM and without RHPC. MH with RHPC without ERM and MH with RHPC and ERM. MH with ERM: Brilliant blue stains the internal limiting membrane (ILM) irregularly due to the ERM, once the ERM is removed, brilliant blue is reapplied and a uniform stain of the ILM is achieved. MH with posterior vitreous cortex: Brilliant blue stains irregularly the ILM, the posterior vitreous cortex is removed along with the ILM.

Conclusions:

The complete removal of the vitreomacular interface is fundamental for surgical and anatomical success in various macular pathologies. The use of markers and dyes facilitates correct identification. We suggest double marking with triamcinolone acetonide, marking and dye (triamcinolone acetonide and brilliant blue), and double dye with brilliant blue to ensure complete removal of ILM.

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