[Treatment of full-thickness macular holes by vitreoretinal surgery].

PURPOSE

To assess the benefit of vitreous surgery in treating patients with full thickness macular holes (stages II to IV from Gass), we report anatomic and visual statements before and after operation in a series of 12 consecutive eyes (3 holes stage II and 9 holes stage III).

METHODS

Visual acuity and anatomical status of the eye before and after the operation were retrospectively reviewed. Surgery included vitrectomy with care to remove the posterior cortical vitreous and relief of all tangential tractions at the posterior pole, retinal tamponade with intraocular gas and face down position for one week.

RESULTS

Postoperatively anatomic success was achieved in 83% cases. Mean preoperative as postoperative visual acuity was 0.4, but postoperative visual acuity was improved at least one line in 66% cases. A secondary cataract was observed in 42% cases within 3 months postoperatively and a transient postoperative intraocular hypertonia (30 to 50 mm Hg) was found in 83% cases within 3 days after the operation. It could be successfully treated in each case with diamox p.o. No case of retinal ischemia was observed.

CONCLUSIONS

Macular hole surgery provides retinal reattachement and meaningful improvement in visual acuity in selected cases. Vitreous surgery is the treatment of choice for constitued macular holes.