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Additional gas injection after failed macular hole surgery with internal limiting membrane peeling
Takeshi Iwase1, Kazuhisa Sugiyama
1Toyama Prefectural Central Hospital, Toyama, and Kanazawa University Graduate School of Medical Science, Japan. tsuyoshiiwase@aol.com
Clinical & Experimental Ophthalmology
|April 14, 2007
Summary
An additional intravitreal gas injection effectively closes macular holes that did not close after initial surgery. This simple procedure improved vision in all treated eyes, matching outcomes of successful primary surgeries.
Area of Science:
- Ophthalmology
- Retinal Surgery
Background:
- Macular hole surgery aims for primary closure.
- Failure of primary closure can occur despite initial surgical success.
Purpose of the Study:
- To evaluate the efficacy of additional intravitreal gas injection for persistent macular holes.
- To assess visual outcomes after repeat gas tamponade for failed macular hole surgery.
Main Methods:
- Patients underwent vitrectomy, ILM peeling, and gas tamponade (20% sulphur hexafluoride) with face-down positioning.
- Eyes with persistent macular holes received an additional intravitreal gas injection.
- Face-down positioning was maintained post-injection.
Main Results:
- Seven of 40 eyes (17.5%) required additional gas injection after primary surgery failure.
- All seven eyes achieved macular hole closure within a mean of 4.1 days post-injection.
- Visual acuity improved in all seven eyes, with final outcomes comparable to successful primary closures.
Conclusions:
- Additional intravitreal gas injection is a highly effective treatment for open macular holes post-primary surgery failure.
- This repeat intervention offers a favorable visual outcome for previously unsuccessful cases.
