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Stage III macular hole surgery

J Orellana¹, R M Lieberman

¹Department of Ophthalmology, Mount Sinai School of Medicine, New York.

The British Journal of Ophthalmology

|September 1, 1993

Summary

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Macular hole surgery using pars plana vitrectomy and membrane peeling can successfully close stage III macular holes. Successful closure, achieved in 58.3% of patients, led to significant visual acuity improvement after six months.

Area of Science:

Ophthalmology
Retinal Surgery

Background:

Macular holes are a common cause of central vision loss.
Stage III macular holes present a surgical challenge with variable outcomes.

Purpose of the Study:

To evaluate the efficacy of pars plana vitrectomy and epiretinal membrane resection with intravitreal gas tamponade for stage III macular hole repair.
To assess visual acuity outcomes and complications following this surgical approach.

Main Methods:

Twelve patients with stage III macular holes underwent pars plana vitrectomy and epiretinal membrane resection.
Intravitreal gas tamponade was used for macular hole closure.
Patients were followed for a mean of 14 months postoperatively.

Main Results:

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Successful macular hole closure was achieved in 7 of 12 patients (58.3%).
Eyes with successful closure showed visual acuity improvement of more than two Snellen lines, typically after six months.
Complications included one case of retinal dialysis, three instances of minimal lenticular opacities, and one case of altered perifoveal pigment epithelium.

Conclusions:

Pars plana vitrectomy with epiretinal membrane resection and gas tamponade is an effective surgical option for stage III macular holes.
Visual recovery can be delayed, with improvements noted at six months or later post-surgery.
The procedure can restore central visual acuity, even in longstanding macular holes.