[Treatment by internal tamponade of retinal detachment with a macular hole]

The authors analyse the operative results of 92 cases of retinal detachment with macular hole, treated by internal tamponade, since 1976. Three technics were used: vitrectomy + silicone oil injection (75 cases), vitrectomy + SF6 gas injection (9 cases), intra-ocular liquid suction + SF6 gas injection (8 cases). Silicone vitrectomy is particularly advisable in the case of large, old retinal detachment with proliferative vitreoretinopathy. This form of treatment is imperative when there is no hope of a satisfactory postoperative positioning, or after an unsuccessful gas treatment due to epiretinal macular membrane. Suction gas is a new and simple technique which is recommended when the macular hole is isolated and without epiretinal membranes. A lattice pattern argon-laser retinopexy is performed, by means of a series of laser impacts at the posterior pole, up to the edge of the macular hole. Treatment of isolated macular holes in a flexible retina by silicone vitrectomy achieved a 78.5% success rate; suction + gas achieved a similar success rate; this last method appears to be the ideal first choice for most of the cases, i-c the two failures which were subsequently turned into successes by silicone vitrectomy.