A new approach to treating retinal detachment with macular hole

Six consecutive cases of retinal detachment with macular hole were treated successfully by vitrectomy, partial gas-fluid exchange, and prone positioning of the patient for 12 hours. Macular coagulation and macular buckling were not necessary. In five cases the retina remained flat during follow-up periods ranging from one to 16 months. In one case a small detachment recurred 13 months after surgery. A renewed partial gas-fluid exchange resolved the problem. This new technique simplifies the treatment of such cases and macular function is preserved rather than destroyed. We believe than many detachments with macular holes are caused by vitreous traction.