First Author: A.Youssef FRANCE
Co Author(s): S. el Khoury K. Zaarour M. Amro G. Cherfan
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To evaluate the closure rate and visual outcome of macular hole (MH) surgery including silicone oil tamponade, vitrectomy, peeling of the internal limiting membrane (ILM), macular endodrainage and perimacular mechanical manipulation. The latter is an additional surgical step, and the present paper is the first description of its effect on surgical outcome
Beirut Eye Specialist Hospital
In this retrospective consecutive case series, we evaluated visual outcome and closure rate of 35 eyes (35 patients) with idiopathic MH. After performing core-vitrectomy and posterior hyaloid detachment, the ILM was stained with indocyanine green and then peeled. Subsequently, macular endodrainage and perimacular manipulation were performed with a silicone-tipped backflush and the eye was filled with silicone oil.
Mean age of patients was 69 years (SD: 6.4 years) with a female-to-male ratio of 4:1. One eye had a stage 2 MH, 15 a stage 3 and 19 a stage 4. Primary closure rate after first surgery was 91.4%. Final closure rate after second surgery was 85.7%, with 2 patients developing a reopening of the hole. Mean visual acuity improved 4.23 lines (range: -2 to 12; p<0.01) from baseline to 3 months after silicone oil removal.
MH surgery with ILM peeling, macular endodrainage, perimacular manipulation and silicone oil tamponade has a high success rate and a good visual outcome. It can be an alternative to gas tamponade in patients who are unable to maintain a face-down position or who need to undergo a travel with high altitude changes in the short postoperative period.