Additional gas injection after failed macular hole surgery with internal limiting membrane peeling
Article first published online: 11 APR 2007
Clinical & Experimental Ophthalmology
Volume 35, Issue 3, pages 214–219, April 2007
How to Cite
Iwase, T. and Sugiyama, K. (2007), Additional gas injection after failed macular hole surgery with internal limiting membrane peeling. Clinical & Experimental Ophthalmology, 35: 214–219. doi: 10.1111/j.1442-9071.2007.01455.x
- Issue published online: 11 APR 2007
- Article first published online: 11 APR 2007
- Received 1 April 2006; accepted 8 September 2006.
- failure macular hole;
- internal limiting membrane;
- macular hole;
- sulphur hexafluoride injection;
Purpose: To report the efficacy of additional intravitreal gas injection in eyes where primary failure occurred following apparently successful macular hole surgery.
Methods: Patients presenting with macular hole underwent a primary surgical procedure consisting of vitrectomy with phacoemulsification and intraocular lens implantation. The internal limiting membrane was stained with indocyanine green and peeled. At the end of this manoeuvre a fluid–gas exchange was performed and the macular hole tamponaded with 20% sulphur hexafluoride. The patients were instructed to assume a face-down position for 12 h per day until the macular hole closed. In those cases where primary closure was not achieved, an additional quantity of 20% sulphur hexafluoride was injected into the vitreous cavity via a 27-gauge needle connected to a 5-mL syringe. The patients were instructed to assume the same position.
Results: A total of 40 eyes from 40 consecutive patients underwent primary macular hole surgery. The macular hole was not successfully closed in seven eyes and a further gas injection was made in these eyes. This additional procedure led to macular hole closure in all cases within a mean of 4.1 days. Visual acuity improved in all seven eyes, and the final visual outcomes were no worse than those eyes that had successful primary closure.
Conclusions: Additional gas injection is an effective treatment for eyes with open holes following unsuccessful primary surgery.