Repeat gas insufflation for successful closure of idiopathic macular hole following failed primary surgery.
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Date
2014-03
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Abstract
A 65‑year‑old lady presented with decreased vision in left eye
since seven months. Vision was 6/9 in right eye and 6/36 in left.
Examination revealed idiopathic, full‑thickness macular hole
in left eye; confirmed by optical coherence tomography (OCT).
Patient underwent phacoemulsification with intraocular lens (IOL)
implantation, vitrectomy, internal limiting membrane (ILM) peeling
and 14% C3F8 gas injection. OCT repeated after six weeks revealed
type II closure with cuff of subretinal fluid. Four weeks later, patient
underwent fluid–gas exchange with 14% C3F8 gas and postoperative
positioning. OCT was repeated after two weeks, which showed
complete closure of the macular hole. OCT can help in selection
of eyes for re‑surgery that stand a better chance for hole closure.
Macular holes with cuff of subretinal fluid are probably more likely
to close on re‑surgery than those without. However, larger studies
with longer follow‑up are required to validate this finding.
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Keywords
Internal limiting membrane, macular hole, optical coherence tomography, re‑surgery, vitrectomy
Citation
Rishi Pukhraj, Reddy Sumanth, Rishi Ekta. Repeat gas insufflation for successful closure of idiopathic macular hole following failed primary surgery. Indian Journal of Ophthalmology. 2014 Mar ; 62 (3): 363-365.