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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


Authors: M. Veith;  Z. Straňák;  M. Penčák;  P. Studený
Authors‘ workplace: Oftalmologická klinika FN Královské Vinohrady a 3. LF UK, Praha, přednosta prof. MUDr. Pavel Kuchynka, CSc.
Published in: Čes. a slov. Oftal., 71, 2015, No. 3, p. 170-174
Category: Original Article

Overview

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.

Key words:
macular hole, 25-gauge, ILM peeling, brilliant blue, gas tamponade


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