Outcome of autologous platelet concentrate and gas tamponade compared to heavy silicone oil tamponade in persistent macular hole surgery

2020 ◽  
pp. 112067212090370 ◽  
Author(s):  
Friederike Schaub ◽  
Nasir Gözlügöl ◽  
Corinna von Goscinski ◽  
Philip Enders ◽  
Ludwig M Heindl ◽  
...  
Keyword(s):  
Macular Hole ◽  
Pars Plana Vitrectomy ◽  
Sulfur Hexafluoride ◽  
Silicone Oil ◽  
Platelet Concentrate ◽  
Heavy Silicone Oil ◽  
Autologous Platelet Concentrate ◽  
Pars Plana ◽  
Autologous Platelet ◽  
Hole Closure

Purpose: Persistence represents the major reason for failure of primary macular hole repair. A variety of surgical approaches are available for treating persistent macular holes. To compare clinical outcome of re-pars plana vitrectomy combined with autologous platelet concentrate and sulfur hexafluoride 20% gas tamponade with heavy silicone oil in persistent macular hole. Methods: Records of 48 consecutive eyes with persistent macular holes which underwent re-pars plana vitrectomy with either heavy silicone oil (35 eyes, persistent macular–hole minimum linear diameter: 518.8 ± 171.1 µm) or autologous platelet concentrate and sulfur hexafluoride 20% (13 eyes, persistent macular hole–minimum linear diameter: 454.1 ± 211.3 µm) were reviewed retrospectively. All patients underwent measurements of anatomical persistent macular hole characteristics evaluated by optical coherence tomography and visual function. Cases in which anatomical success failed after first re-pars plana vitrectomy were treated with the other surgical techniques, comparable to a cross-over design. Results: Persistent macular hole closure rate was 57.1% with autologous platelet concentrate and sulfur hexafluoride 20% and 45.7% with heavy silicone oil ( p = 0.102). Functional results were comparable when persistent macular hole closure was achieved ( p ⩾ 0.741), but significantly better for the autologous platelet concentrate with sulfur hexafluoride 20% group when persistent macular hole closure failed ( p = 0.019). Conclusion: Re-pars plana vitrectomy combined with autologous platelet concentrate and sulfur hexafluoride 20% seems to achieve at least non-inferior persistent macular hole closure rates and comparable functional results when compared to heavy silicone oil, suggesting autologous platelet concentrate and sulfur hexafluoride 20% as a safe surgical alternative in persistent macular hole. Especially when persistent macular hole closure failed, autologous platelet concentrate with sulfur hexafluoride 20% seems to be superior regarding visual outcome.

scholarly journals Posterior pole retinotomy for treatment of recurrent macular hole retinal detachment in highly myopic eyes: a pilot study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xianggui Wang ◽  
Xuezhi Zhou ◽  
Ying Zhu ◽  
Huizhuo Xu
Keyword(s):  
Retinal Detachment ◽  
Macular Hole ◽  
Pars Plana Vitrectomy ◽  
Silicone Oil ◽  
Posterior Pole ◽  
Macular Holes ◽  
Macular Hole Retinal Detachment ◽  
Pars Plana ◽  
Silicone Oil Tamponade ◽  
Hole Closure

Abstract Background To investigate the feasibility and efficacy of posterior pole retinotomy to treat recurrent macular hole retinal detachment (MHRD) in highly myopic patients. Methods We performed a retrospective study and reviewed the medical records in our hospital between January 1, 2016 and December 31, 2018. Highly myopic patients who received posterior pole retinotomy with silicone oil tamponade for their recurrent MHRD after pars plana vitrectomy were included in the analysis. Postoperative retinal reattachment, best-corrected visual acuity (BCVA), macular hole closure, and complications were evaluated. Results There were 11 patients (11 eyes) included in this study. All retinas were reattached. Silicone oil was successfully removed from all eyes 1.5–3 months after the surgery. Macular holes were completely closed in three eyes and remained flat open in eight eyes. The BCVA of all eyes improved significantly at 12 months after surgery (logarithm of the minimal angle of resolution, pre vs. postoperatively, 1.87 ± 0.44 vs. 1.15 ± 0.24, P < 0.05). None of the patients had complications such as endophthalmitis, fundus hemorrhage, retinal redetachment, and proliferative vitreoretinopathy. Conclusion Posterior pole retinotomy is a safe and effective surgery to treat recurrent MHRD after pars plana vitrectomy in highly myopic patients.

Pars plana vitrectomy with silicone oil tamponade for primary and secondary macular hole closure: Is it still a useful procedure?

2018 ◽  
Vol 28 (5) ◽  
pp. 503-514 ◽  
Author(s):  
Janusz Pieczynski ◽  
Patrycja Kuklo ◽  
Andrzej Grzybowski
Keyword(s):  
Visual Acuity ◽  
Macular Hole ◽  
Pars Plana Vitrectomy ◽  
Silicone Oil ◽  
Surgical Techniques ◽  
Successful Outcome ◽  
Gas Tamponade ◽  
Pars Plana ◽  
Silicone Oil Tamponade ◽  
Hole Closure

Purpose: To evaluate usefulness of posterior vitrectomy with silicone oil tamponade for primary and secondary macular hole closure. Methods: We searched for publications on the surgical treatment of full-thickness idiopathic and recurrent macular hole. We divided reports into two groups: primary macular hole repair and recurrent macular hole repair with silicone oil tamponade. Results: In primary macular hole treatment, different authors confirmed effectiveness of silicone oil tamponade. They suggest that the most important factor for successful outcome was completeness of vitreous cavity filling with oil. Complications after this method were comparable to those after gas tamponade. However, even if good anatomical results are achieved in secondary macular hole closure, visual acuity is sometimes less rewarding. Conclusion: There are reports on good efficacy of silicone oil tamponade for primary and recurrent macular hole closure. Anatomical closure and visual acuity rates in pars plana vitrectomy with silicone oil and with gas filling are comparable. Gas tamponade seems to be safer and needs no more surgery. Postoperative complications in both methods are similar, but all patients with silicone oil filling need to undergo a reoperation to have the silicone removed. There are also other surgical techniques for primary macular hole closure as well as for unsuccessful primary macular hole procedures. We think that primary macular hole closure should be performed with gas tamponade, supported with different adjuvants, as a method of choice. Silicone oil tamponade could be still an alternative in cases, when there are no more efficient techniques or possibilities to treat with success recurrent macular hole.

Autologous Platelet Concentrate as an Adjunct in Macular Hole Healing

Ophthalmology ◽  
1996 ◽  
Vol 103 (4) ◽  
pp. 590-594 ◽  
Author(s):  
Jean-François Korobelnik ◽  
Daniele Hannouche ◽  
Nacera Belayachi ◽  
Michel Branger ◽  
Jean-Eric Guez ◽  
...  
Keyword(s):  
Macular Hole ◽  
Platelet Concentrate ◽  
Autologous Platelet Concentrate ◽  
Hole Healing ◽  
Autologous Platelet

scholarly journals A Female Case of X-Linked Retinoschisis with Macular Hole Bilaterally

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
A. Altun
Keyword(s):  
Visual Acuity ◽  
Macular Hole ◽  
Pars Plana Vitrectomy ◽  
Silicone Oil ◽  
Surgical Experience ◽  
Flap Technique ◽  
Macular Holes ◽  
Female Case ◽  
Pars Plana

Purpose. We aimed at reminding that X-linked retinoschisis may also be seen in female patients and share our vitreoretinal surgical experience. Methods. The patient underwent pars plana vitrectomy including the closure of the macular holes with inverted ILM flap technique bilaterally. Lens extractions were performed by phacoemulsification during the removal of silicone oil endotamponade. Patient. An 18-year-old girl with X-linked retinoschisis and large macular holes in both eyes presented to the clinic of ophthalmology. It was confirmed that the patient had RS1 mutation Results. Nine-month-follow-up was uneventful for retinal findings. Significant improvement in visual acuity was achieved, and macular holes were remained closed. Conclusion. In cases with large macular holes due to XLR, an inverted ILM flap technique might be safe and effective. Four-month-silicone-endotamponade might be sufficient.

Vitreomacular interface alterations following peripheral laser retinopexy: Interface changes after laser

2019 ◽  
Vol 30 (5) ◽  
pp. 941-947
Author(s):  
Gian Marco Tosi ◽  
Tommaso Bacci ◽  
Antonio Tarantello ◽  
Davide Marigliani ◽  
Giacomo Calmanti ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Macular Hole ◽  
Pars Plana Vitrectomy ◽  
Control Analysis ◽  
Optical Coherence ◽  
Vitreomacular Adhesion ◽  
Mean Width ◽  
Pars Plana ◽  
Laser Group ◽  
Hole Closure

Aim: To demonstrate the morphological outcomes of macular hole following prophylactic peripheral laser retinopexy (PPLR). Methods: Our retrospective case-control analysis included 92 eyes, 55 in the laser group and 37 in the non-laser group. Fifty-five patients were subjected to prophylactic peripheral laser retinopexy in preparation for pars plana vitrectomy for macular hole, with and without vitreomacular adhesion (laser group). Before and after prophylactic peripheral laser retinopexy, we evaluated any changes in vitreomacular anatomy by optical coherence tomography. Optical coherence tomography changes were also analyzed in the visits preceding pars plana vitrectomy in 37 macular hole eyes not subjected to prophylactic peripheral laser retinopexy (non-laser group). Results: In the laser group, 7 out of 55 eyes (12.7%) showed macular hole closure (6 out of 18 macular hole eyes with vitreomacular adhesion (33.3%) and 1 out of 37 eyes without vitreomacular adhesion (2.7%)), while no patients showed macular hole closure in the non-laser group (p < 0.05). The mean width of the seven closed macular hole was 191.4 µm (range: 59–282 µm). In all except one of the six macular hole eyes with vitreomacular adhesion, the macular hole closed without vitreomacular adhesion release. In our analysis of the patient subgroup with vitreomacular adhesion, we observed a release of vitreomacular adhesion in 3 out of 18 eyes (16.6%) in the laser group and in 1 out of 13 eyes (7.6%) in the non-laser group (p > 0.05). Conclusion: These findings support a possible beneficial role for prophylactic peripheral laser retinopexy in selected individuals with macular hole.

scholarly journals The outcome of vitrectomy with internal limiting membrane peeling for chronic macular hole at Biratnagar eye hospital: A tertiary eye care center in Nepal

2016 ◽  
Vol 7 (6) ◽  
pp. 43-46
Author(s):  
Lalit Agarwal ◽  
Nisha Agrawal ◽  
Pratap Karki ◽  
Abhishek Anand
Keyword(s):  
Macular Hole ◽  
Pars Plana Vitrectomy ◽  
Internal Limiting Membrane ◽  
Internal Limiting Membrane Peeling ◽  
Chronic Stage ◽  
Visual Improvement ◽  
Macular Holes ◽  
Pars Plana ◽  
Hole Closure

Background:  A macular hole is a full-thickness defect of retinal tissue involving the anatomic fovea, thereby affecting central visual acuity. Pars plana vitrectomy and gas tamponade is a recognised modality of treatment for macular hole.Larger holes are more likely to remain open after repair and late reopening after an initially closed macular hole is seen in macular holes larger than 400 μm.Aims and Objective: To evaluate the anatomical and functional outcome of pars plana vitrectomy with internal limiting membrane peeling for chronic stage 3 macular hole.Materials and Methods: Records of 15 patients with stage 3 chronic macular holes operated from 1st January 2013 to 30th June 2013 and completed 1 year of follow up were retrospectively evaluated and included in the study. Preoperative best distance corrected visual acuity (BCVA), preoperative macular hole size, final BCVA and macular hole status at 1 year follow up were recorded. Macular hole closure and visual improvement was calculated. Correlation of macular hole closure and visual improvement with various macular hole parameter was estimated.Results: Eleven (73.3%) macular holes closed at 1 year follow-up. Mean BCVA improved from 1.2 ± 0.27 to 0.89 ± 0.36 logarithm of minimum angle of resolution at 1 year (p<0.001). Visual improvement was seen in only eight (53.3%) eyes. Both macular hole closure and visual improvement showed no correlation with minimum linear diameter, base diameter and hole height.Conclusion: Chronic stage 3 macular hole can be closed successfully in majority of patients with fairly good visual improvement. Macular hole parameters of stage 3 holes may not have any correlation with the anatomical and visual outcome.Asian Journal of Medical Sciences Vol.7(6) 2016 43-46

Air vs Gas Tamponade During Macular Hole Repair Surgery

2020 ◽  
Vol 4 (5) ◽  
pp. 360-363
Author(s):  
Shriji N. Patel ◽  
Janice Law ◽  
Edward Cherney ◽  
Franco Recchia ◽  
Stephen J. Kim
Keyword(s):  
Macular Hole ◽  
Sulfur Hexafluoride ◽  
Final Analysis ◽  
Gas Tamponade ◽  
Macular Holes ◽  
Full Thickness Macular Hole ◽  
Significant Difference ◽  
Pars Plana ◽  
Operative Report ◽  
Hole Closure

Purpose: This work investigates the visual and anatomical outcomes of full-thickness macular hole (FTMH) repair surgery using air in comparison to gas tamponade. Methods: A retrospective consecutive review of medical records was undertaken of all patients undergoing pars plana vitrectomy for idiopathic FTMH at an academic practice from January 2010 to May 2017. Each operative report was reviewed to investigate the agent used for tamponade at the end of the surgery. Preoperative hole duration and size as measured using optical coherence tomography as well as successful postoperative hole closure were recorded. Use of gas or air was not randomized and was instilled at surgeon discretion. Results: The final analysis included 211 eyes. Gas was used as the tamponade agent in 171 of the 211 eyes; most of these eyes (144 of 171) received sulfur hexafluoride (SF6) and the remainder received perfluoropropane (C3F8). Forty eyes underwent only a complete fluid-air exchange without any gas placement following vitrectomy. There was no statistically significant difference between the 2 groups in mean preoperative macular hole size ( P = .43). Nine of the 171 macular holes receiving gas tamponade failed to close (5.3%). One of the 40 macular holes receiving only air failed to close (2.5%). There was no statistically significant difference in hole closure rates between the 2 groups ( P = .45). Conclusions: Air served as an equally efficacious internal tamponade agent in comparison to nonexpansile gas following idiopathic FTMH repair surgery.

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