Surgical treatment of the idiopathic macular hole by means of 25-gauge pars plana vitrectomy with the peeling of the internal limiting membrane assisted by brilliant blue and gas tamponade
Abstract
Aim: 25-gauge pars plana vitrectomy with briliant blue assisted internal limiting membrane peeling and gas tamponade for idiopatic macular hole. Purpose: The evaluation of anatomic and visual outcomes in idiopatic macular holes treated with 25-gauge pars plana vitrectomy, briliant blue (BB) assisted internal limiting membrane (ILM) peeling and gas tamponade.
Materials and methods: Retrospective analysis. 53 eyes of 52 patients (39 women, 13 men) of mean age 68,8 years (58-83) with the diagnosis of stage 2, 3, or 4 macular holes according to Gass Classification from 6/2012 to 7/2014 were included. All patient undergone 25-gauge pars plana vitrectomy with brillinat blue assisted ILM peeling, gas tamponade (35 cases 15 % C3F8, 18 cases 20 % SF6). 50 cases (94,3 %) were performed in retrobulbar anesthesia, 3 cases in general anesthesia.
Face-down positioning should have beeen maintained for three days. Best corrected visual acuity (BCVA), optical coherence tomography findings and complications were evaluated.
Results: The mean follow-up time was 6 months (1-22). Macular hole closure was achieved in 49 eyes (92,5 %).
The mean BCVA improved from 0,16 (0,5-0,05) to 0,5 (1,0-0,1). BCVA was improved by 3 and more ETDRS lines in 42 eyes (79,2 %).
Conclusion: 25-gauge pars plana vitrectomy with briliant blue assisted internal limiting membrane peeling and gas tamponade is safe and effective method of macular hole therapy with high anatomic and functional effect.