scholarly journals Pars Plana Vitrectomy With Silicone Oil Versus Sulphur Hexafluride Gas Tamponade For Idiopathic Macular Hole

2021 ◽  
Vol 0 (0) ◽  
pp. 0-0
Author(s):  
MOHAMED IBRAHIM ◽  
Ahmed Barrada ◽  
Mahmoud Ali
2018 ◽  
Vol 28 (5) ◽  
pp. 503-514 ◽  
Author(s):  
Janusz Pieczynski ◽  
Patrycja Kuklo ◽  
Andrzej Grzybowski

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.


2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
A. Altun

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.


2021 ◽  
pp. 247412642110189
Author(s):  
Scott Grant ◽  
Sean D. Adrean

Purpose: This work aims to evaluate the outcomes of a series of macular hole (MH) surgical procedures in patients who had pars plana vitrectomy (PPV) with internal limiting membrane (ILM) peel and without gas tamponade. Methods: Patients from a retina specialty clinic who had MHs were identified for this interventional case series. Patients with small MHs were offered inclusion into the trial. Patients with larger MHs were excluded. They underwent standard 3-port PPV and ILM peel without gas or air to treat small MHs. The main outcomes that we measured were closure of MH and visual results. Results: Small MHs in 5 patients were managed with PPV and ILM peel alone. The average preoperative hole size at its narrowest width was 227 µm (range, 173-294 µm). Four of 5 patients (80%) had successful hole closure without a gas tamponade and improved vision; 1 patient did not have hole closure and was treated with an in-office gas bubble to close the hole. The average preoperative vision at 3 months was 20/80– (54 Early Treatment Diabetic Retinopathy Study [ETDRS] letters) and improved to 20/30–2 (73 ETDRS letters) in the 4 patients whose MHs were closed with surgery without a gas bubble. This was statistically significant ( P = .003). The hole that did not close initially without gas tamponade was the largest in the series. Conclusions: Patients with small MHs can be successfully treated with a vitrectomy and ILM peel alone without a gas tamponade.


2020 ◽  
Author(s):  
Yifan Zhou ◽  
Siqi Zhang ◽  
Min Gao ◽  
Hao Zhou ◽  
Haiyun Liu ◽  
...  

Abstract Purpose: To investigate different fundus vasculature and structure changes after single pars plana vitrectomy (PPV) following silicone oil (SO) or sterilized air in macular-off rhegmatogenous retinal detachment (RRD) patients. Method: 39 eyes (39 patients) with macular-off RRD underwent standard three-port 23-gauge PPV and intraocular SO or gas tamponade. Optical Coherence Tomography (OCT) and angiography were used to evaluate fundus structure and vasculature including retinal layers thicknesses and vessel density (VD) changes throughout observation for 12 weeks. Retinal layers were segmented into: NFL, GCL+IPL, INL, OPL, ONL+IS, OS+RPE and BRM. Fundus vasculature was segmented into superficial and deep capillary plexus (SCP, DCP), and choriocapillaris plexus (CCP). Result: For fundus vasculature, SO tamponade led to significant decrease in both SCPVD and DCPVD, while only SCPVD was found significantly decreased in gas tamponade eyes. For specific retinal layer, SO led to significant decrease in NFL and INL thicknesses. OPL, ONL+IS and OS+RPE thicknesses had significant increase in both SO tamponade and gas tamponade eyes. Conclusion: Different intraocular tamponades could have various impacts on retinal vasculature and structure. Compared to sterilized air, silicone oil tamponade could have relatively more negative effects on retinal vasculature and specific retinal layer thickness change.


2016 ◽  
Vol 27 (1) ◽  
pp. 93-97 ◽  
Author(s):  
Libor Hejsek ◽  
Alexandr Stepanov ◽  
Jaroslava Dusova ◽  
Jan Marak ◽  
Jana Nekolova ◽  
...  

Purpose To evaluate the success of a mini-invasive technique for operation of idiopathic macular hole (IMH). Methods We retrospectively examined 29 patients (30 eyes) in whom 25-G pars plana vitrectomy (PPV), peeling of the inner limiting membrane (ILM), and application of air tamponade were performed. The group of the patients included 7 males and 22 females (76%), age range 57-79 years (median 70). The follow-up period was 3-47 months (median 17). Results Pars plana vitrectomy was indicated only in the stages of full-thickness macular hole. Prior to operation, 13 eyes (43%) were in stage 2, 15 eyes (50%) in stage 3, and 2 eyes (7%) in stage 4. The IMH healed in 28 eyes after operation. Persistence of IMH occurred in 2 eyes (7%). After subsequent reoperation with extension of the peeling zone of the ILM and gas tamponade (with 10% C3F8), these macular holes also healed (100%). Prior to carrying out PPV, best-corrected visual acuity (BCVA) ranged between 20/40 and 20/500 (median 20/125). At the end of the follow-up period, BCVA was improved to 20/40 (median). The change in the final BCVA compared to the initial visual acuity was statistically significant (p = 0.008; Wilcoxon). Conclusions The 25-G PPV with peeling of the ILM and air tamponade is an effective technique and presents no increased risks in comparison with routine procedures. The main benefit of the intervention is its good tolerance by the patient, particularly with respect to painfulness and postoperative irritation.


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