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Post-vitrectomy macular holes-results of re-operation vitrectomy

Session Details

Session Title: Vitreoretinal Surgery II

Session Date/Time: Friday 12/09/2014 | 14:30-16:00

Paper Time: 15:42

Venue: Boulevard C

First Author: : H.Yetík TURKEY

Co Author(s): :    S. Sirop   C. Dogan   M. Gunay        

Abstract Details

Purpose:

To investigate the results and success rates of re-operation vitrectomy performed for secondary macular holes developed after previous vitrectomy surgeries performed for indications excepting macular hole

Setting:

Clinical practice of interventional case series in Surp Pırgic Armenian Hospital of Istanbul Turkey

Methods:

12 cases of secondary holes developed after a previous vitrectomy and re-operated for repairment of the macular hole in the period of January 2008 to August 2013 included in the study. Indications for previous vitrectomy and present characteristics of the cases were as follows: 3 rhegmatogenous retinal detachment all of which still filled with silicone oil; 5 ocular trauma 4 still filled with silicone oil 1 silicone removed 2 years ago; 4 proliferative diabetic retinopathy 3 still filled with silicone oil 1 silicone oil removed 2 years ago. Surgical technique: under conventional 3 port vitrectomy setting if the eye is still filled with silicone oil firstly silicone oil was removed by active suction; fluid air exchange performed and brilliant blue applied under air; air-fluid exchange was performed; ILM peeling- there was ILM to be removed in 6 of 12 cases but it was previously removed in other 6; detailed cleaning of hole margin and hole base by ILM forceps performed for all cases; fluid air exchange drying of the hole by silicone tip flute needle and closing sclerotomies with the eye filled by pure air. No prone positioning was offered. Patients were followed up for 28,75± 24,558 moths.

Results:

5 days after the surgery air level was almost above the macular hole and macular hole was closed ophthalmoscopically and closing was demonstrable by and OCT. Air totally disappeared 10 days after the surgery. Mean 3,961± 1,621 lines increase was observed. There was no important complication i.e. re-opening of the hole throughout the study period

Conclusions:

Post-vitrectomy macular holes are the cases most of which are left its natural course generally depending upon our experience. There is not enough literature data about the best surgical option as well as if they are worth to re-operate in the means of either anatomical or functional results. This study results demonstrate that post-vitrectomy macular hole are worth to re-operate and high anatomical and functional results can be gained by ILM peeling, cleaning of hole margins and hole base and air tamponade

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