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Silicone oil microbubble found in failed full-thickness macular hole closure
Matthew J Welch1, Stephen A M De Souza
1*Suburban Retina, Ltd, Lombard, Illinois; †Associated Retina Consultants, Ltd, Phoenix, Arizona; and ‡Department of Ophthalmology, Loyola University Chicago, Stritch School of Medicine, Maywood, Illinois.
Purpose:
To describe a case of failed macular hole closure after vitrectomy with silicone oil tamponade because of a silicone oil microbubble.
Methods:
This is a retrospective case review of a single patient's clinical course.
Results:
Because of the inability of the patient to assume a prone position after vitrectomy for full-thickness macular hole, 1000-centistoke silicone oil tamponade was used at the initial repair. Optical coherence tomography showed persistent full-thickness macular hole with evidence of a silicone oil microbubble within the macular hole. Subsequent vitrectomy with the removal of silicone oil and exchange for 25% sulfur hexafluoride (SF6) gas with attempted prone positioning failed to provide hole closure. Successful hole closure was accomplished after tamponade with 5000-centistoke silicone oil, without prone positioning. No recurrence of the full-thickness defect was seen after the eventual removal of 5000-centistoke silicone oil.
Conclusion:
It is possible that the silicone oil microbubble formation and migration within a full-thickness macular hole defect may contribute to surgical failure.
