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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.
Retinal Cases & Brief Reports
|November 6, 2014
Summary
A silicone oil microbubble may hinder macular hole closure after vitrectomy. Higher viscosity silicone oil successfully closed the macular hole in a challenging case, suggesting its potential in complex retinal surgeries.
Area of Science:
- Ophthalmology
- Retinal Surgery
Background:
- Macular hole surgery aims for anatomical closure and visual recovery.
- Silicone oil tamponade is used in complex cases, particularly when prone positioning is not feasible.
Observation:
- A patient with a full-thickness macular hole failed closure after vitrectomy with 1000-centistoke silicone oil tamponade.
- Optical coherence tomography revealed a silicone oil microbubble within the macular hole, potentially impeding closure.
Findings:
- Subsequent surgery with sulfur hexafluoride (SF6) gas and attempted prone positioning also failed to achieve hole closure.
- Successful closure was eventually obtained using 5000-centistoke silicone oil without the need for prone positioning.
Implications:
- Silicone oil microbubble formation and migration may be a factor in surgical failure for macular hole repair.
- Higher viscosity silicone oil may offer an alternative tamponade in complex macular hole cases unresponsive to standard treatments.
