Programm                 "Degeneration und Regeneration– Grundlagen, Diagnostik und Therapie"

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Macular Hole Surgery with Air Tamponade

Prünte C., Martin M., Kain H. L.
University Eye Clinic, Basel/CH

Purpose: The aim of this pilot study was the evaluation of functional and morphologic recovery after surgery for macular hole using air tamponade.
Method: Pars plana vitrectomy with peeling of the ILM and air tamponade was performed in 15 consecutive patients with macular hole, stage II-III. After surgery the patients were instructed to remain in facedown position for one week with free positioning during meals and some hours during the night. Visual acuity, photo documentation and optical coherence tomography (OCT) were used as follow-up parameters.
Results: In all cases the rims of the macular hole could not be differentiated any more 4 days after surgery and resorption of 2/3 of the air bubble. Furthermore, OCT examination showed a normalized, continuing retinal structure in the fovea in the majority of cases at this early follow-up examination. One week after surgery in 7 cases visual acuity had increased one or more lines with stable visual acuity in the other 8 patients and consecutive improvement over the following month. Progressive cataract could be observed in 47% of the eyes. No reopening of macular holes occurred during the six month observation period.
Conclusions: Our results demonstrate, that successful surgery in macular hole cases can result in evident functional and structural recovery of macular structures after several days. Therefore, air tamponade might be sufficient in these cases.

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