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Pars plana vitrectomy for treatment of stage 2 macular holes
A J Ruby1, D F Williams, M G Grand
1Retina Consultants, Ltd, St Louis, Mo.
Objective:
To assess the anatomic outcome and visual acuities at follow-up after pars plana vitrectomy in the management of stage 2 macular holes.
Design:
Retrospective.
Setting:
Retina Consultants, Ltd, St Louis, Mo.
Patients:
Thirty-three patients, aged 43 to 75 years, with stage 2 macular holes.
Intervention:
Total pars plana vitrectomy with separation of the posterior hyaloid membrane and injection of intraocular gas followed by postoperative face-down positioning.
Main Outcome Measures:
Visual acuity and anatomic appearance of the macular hole.
Results:
Postoperatively, 20 (61%) of 33 eyes attained a visual acuity of 20/50 or greater. Twenty (61%) of 33 eyes showed an improvement in visual acuity, while nine (27%) of 33 were stable. Four (12%) of 33 eyes showed a decline in postoperative visual acuity with progression to a stage 3 macular hole. Twenty-five (76%) of 33 eyes showed stabilization or improvement in the appearance of the macular hole.
Conclusions:
Pars plana vitrectomy in conjunction with postoperative intraocular gas tamponade may result in visual and anatomic stabilization or improvement in eyes with stage 2 macular holes. However, because of limited natural history data, it is unknown whether these results are any better than those that might occur without surgery.