[Pars plana vitrectomy in retinal detachment with a macular hole].

The long-term results of pars plana vitrectomy (PPV) for retinal detachment due to a macular hole were evaluated in 40 eyes of 40 patients. The patients were followed up for 6 to 72 months. In 9 eyes, subtotal PPV with expansive gases was used: in 5 of them, in addition, the macular hole was treated with laser endocoagulation. The operation was successful in 4 out of 5 eyes treated with laser barrage. In the remaining 5 eyes, the operation failed and reattachment was obtained after secondary silicone oil implantation (SOI). In 31 eyes, PPV was combined with a primary SOI. Twenty of them suffered from serious myopic degenerative changes of the posterior eye pole, and in 11 posterior stafyloma. Reattachment of the retina was achieved in 28 eyes (90.3%), visual acuity 1/24 (0.04) or better in 13 eyes (41.9%). Silicone oil was removed in 13 eyes (41.9%), in all these without complications. PPV with expansive gases and laser coagulation proved to be effective in macular holes with the well-preserved pigment epithelium. Silicone oil proved competent in macular holes associated with serious chorioretinal degeneration and posterior stafyloma.