Ultrasonography as a routine examination before treatment of retinal detachment due to macular hole

Twelve of 25 patients were treated at the University Eye Clinic in Münster because of retinal detachment due to a macular hole. Partial fluid gas exchange (SF6), vitrectomy and SF6, or vitrectomy and silicone instillation, were used, and the patients were examined both pre- and postoperatively by ultrasonography with particular attention to the situation at the posterior pole. These echographical examinations enabled us to evaluate the following three criteria: staphyloma posticum, stiffness of the retina, and vitreous adhesions. All of these conditions mean that the prognosis will be worse if SF6 gas instillation is used alone. In these cases, a vitrectomy should also be performed or a Klöti-Klemme procedure is useful when stiffness of the retina or staphyloma posticum is present. Preoperative ultrasonography is useful when setting up an adequate therapy plan.