Özgül ALTINTAŞ, Berna ÖZKAN, Veysel Levent KARABAŞ, Büşra Yılmaz TUĞAN

Limited Vitrectomy in Patients with Idiopathic Macular Hole

Background: Partial posterior hyaloidectomy is suggested to minimize traction on the vitreous base and thus reduce the risk of iatrogenic breaks in patients with macular hole and epiretinal membrane.Aims: To evaluate the safety and efficacy of limited vitrectomy in patients with macular hole.Study Design: Retrospective cohort study.Methods: Fifty-two consecutive patients who underwent macular hole surgery without complete peripheral vitreous removal were included in the study. The improvement in visual acuity, the incidence of retinal breaks and detachment, anatomical results, and intraoperative and postoperative complications of this technique were evaluated.Results: The median visual acuity was 0.2 (0.1-0.4) before surgery and 0.5 (0.3-0.6) after surgery (p

PDF

___

Chin EK, Almeida DR, Sohn EH. Structural and Functional Changes After Macular Hole Surgery: a review. Int Ophthalmol Clin 2014;54:17-27.
Rizzo S, Belting C, Genovesi-Ebert F, di Bartolo E. Incidence of retinal detachment after small-incision, sutureless pars plana vitrectomy compared with conventional 20 gauge vitrectomy in macular hole and epiretinal membrane surgery. Retina 2010;30:1065-71.
Krishnan R, Tossounis C, Fung Yang Y. 20-gauge and 23-gauge phacovitrectomy for idiopathic macular holes: comparison of complications and long-term outcomes. Eye (Lond) 2013;27:72-7.
Issa SA, Connor A, Habib M, Steel DH. Comparison of retinal breaks observed during 23 gauge transconjunctival vitrectomy versus conventional 20 gauge surgery for proliferative diabetic retinopathy. Clin Ophthalmol 2011;20:109-14.
Nakano T, Uemura A, Sakamoto T. Incidence of iatrogenic peripheral retinal breaks in 23-gauge vitrectomy for macular diseases. Retina 2011;31:1997-2001.
Rahman R, Murray CD, Stephenson J. Risk factors for iatrogenic retinal breaks induced by separation of posterior hyaloid face during 23-gauge pars plana vitrectomy. Eye (Lond) 2013;27:652-6.
Chung SE, Kim KH, Kang SW. Retinal breaks associated with the induction of posterior vitreous detachment. Am J Ophthalmol 2009;147:1012-6.
Kim JH, Kang SW, Kim YT, Kim SJ, Chung SE. Partial posterior hyaloidectomy for macular disorders. Eye (Lond) 2013;27:946-51.
Cullinane AB, Cleary PE. Prevention of visual field defects after macular hole surgery. Br J Ophthalmol 2000;84:372-7.
Yagi F, Takagi S, Tomita G. Incidence and causes of iatrogenic retinal breaks in idiopathic macular hole and epiretinal membrane. Semin Ophthalmol 2014;29:66-9.
Guillaubey A, Malvitte L, Lafontine PO, Hubert I, Bron A, Berrod JP, et al. Incidence of retinal detachment after macular surgery: a retrospective study of 634 cases. Br J Ophthalmol 2007;91:1327-30.
Hirokawa H, Jalkl AE, Takahashi M, Takahashi M, Trempe CL, Schepens CL. Role of the vitreous in idiopathic preretinal fibrosis. Am J Ophthalmol 1986;101:166-9.
Wiznia RA. Natural history of idiopathic preretinal macular fibrosis. Ann Ophthalmol 1982;14:876-8.
Tan HS, Mura M, de Smet MD. Iatrogenic retinal breaks in 25-gauge macular surgery. Am J Ophthalmol 2009;148:427-30.
Kamizuru H, Ogura Y. Incidence of peripheral retinal degeneration in eyes with idiopathic macular hole. Jpn J Clin Ophthalmol 1995;49:1095-7.
Zhang J, Li Y, Zhao X, Cai Y, Yu X, Lu L. Relationship between full-thickness macular hole and retinal break/lattice degeneration. Eye Sci 2015;30:156-9.
Essex RW, Kingston ZS, Moreno-Betancur M, Shadbolt B, Hunyor AP, Campbell WG, et al. The Effect of Postoperative Face-Down Positioning and of Long- versus Short-Acting Gas in Macular Hole Surgery. Results of a Registry-Based Study. Ophthalmology 2016;123:1129-36.
Iezzi R, Kapoor KG. No face-down positioning and broad internal limiting membrane peeling in the surgical repair of idiopathic macular holes. Ophthalmology 2013;120:1998-2003.
Elborgy ES, Starr MR, Kotowski JG, Chehade JEA, Iezzi R. No face down positioning surgery for the repair of chronic idiopathic macular holes. Retina 2018.
Hu Z, Xie P, Ding Y, Zheng X, Yuan D, Liu Q. Face-down or no face-down posturing following macular hole surgery: a meta-analysis. Acta Ophthalmol 2016;94:326-33.