Abstract
Background
A variety of treatment strategies have been proposed for macular holes that persist or recur after surgery, and the debate about the best re-treatment approach is ongoing. To allow for a comparison with alternative surgical therapies, we assessed the anatomical and functional outcome of a temporary tamponade with conventional silicone oil in persistent or recurrent full-thickness macular holes.
Methods
We retrospectively investigated consecutive patients with full-thickness macular holes that persisted or recurred following vitrectomy with internal limiting membrane peeling and gas tamponade. All patients received re-treatment by temporary tamponade of silicone oil and were allowed free postoperative positioning. Anatomical closure rate was assessed by optical coherence tomography, and change of best-corrected visual acuity (BCVA) was analyzed.
Results
A total of 33 eyes of 33 consecutive patients were included. Macular hole closure following silicone oil tamponade was achieved in 30 of 33 eyes (90.9%). Median BCVA improved from 1.00 logMAR (interquartile range, 0.60–1.00) to 0.65 logMAR (0.49–1.00; p = 0.010) after silicone oil removal. In patients with macular hole closure, 61.3% exhibited functional improvement with median BCVA changing from 1.00 logMAR (0.70–1.00) to 0.60 logMAR (0.49–1.00; p = 0.0005). Mean minimal linear diameter of macular holes before primary surgery was 391.0 µm (±137.8; range 133–630), and 48.5% of macular holes were >400 µm in diameter.
Conclusions
Treatment of persistent or recurrent full-thickness macular holes by temporary conventional silicone oil tamponade without postoperative positioning results in a high closure rate and a significant mean improvement of visual acuity.
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Change history
13 November 2020
We updated the original HTML version of this Article shortly after publication in order to add the missing Projekt DEAL funding acknowledgement.
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JQL has nothing to disclose. RB has nothing to disclose. FGH reports personal fees from Acucela, grants and personal fees from Allergan, grants and personal fees from Bayer, personal fees from Bioeq, personal fees from Boehringer Ingelheim, grants and personal fees from Carl Zeiss Meditec, grants and personal fees from Genentech, grants and personal fees from Heidelberg Engineering, personal fees from Merz, personal fees from NightstarX, grants and personal fees from Novartis, personal fees from Optos, personal fees from Pixium, personal fees from Roche, and personal fees from Thea, outside the submitted work. TUK reports personal fees from Alimera Sciences, personal fees from Allergan, grants and personal fees from Bayer, personal fees from Heidelberg Engineering, grants and personal fees from Novartis, and personal fees from Roche, outside the submitted work.
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Li, J.Q., Brinken, R., Holz, F.G. et al. Silicone oil tamponade for persistent macular holes. Eye 35, 2206–2212 (2021). https://doi.org/10.1038/s41433-020-01228-9
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DOI: https://doi.org/10.1038/s41433-020-01228-9
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