Arcuate Retinotomy for the Repair of Large Macular Holes

Charles, Steve; Randolph, John; Neekhra, Aneesh; Salisbury, Charles D; Littlejohn, Nathan; Calzada, Jorge I.

doi:10.3928/23258160-20121221-15

Cited by 75 publications

(53 citation statements)

References 9 publications

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“…This might be partly due to the fact that there is little else to do when the posterior hyaloid has been detached and the ILM removed. Several different techniques have been described as adjunctive procedures to attempt closure when reoperating these patients, such as pneumatic retinopexy and repeat fluid–gas exchange,14 PPV with enlargement of previous ILM peel,15 endotamponade with silicone oil16 17 or long-lasting gas,7 radial relaxing retinotomies on the margin of the hole18 and laser photocoagulation,19 among others.…”

Section: Discussionmentioning

confidence: 99%

Internal limiting membrane translocation for refractory macular holes

2016

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Section: Discussionmentioning

confidence: 99%

Internal limiting membrane translocation for refractory macular holes

2016

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“… 57 , 107 A wide variety of other techniques have been reported, including ILM and capsular flaps, retinal relieving incisions, laser, mobilization of the edges of the hole, and drainage of chronic fluid from the center of the hole in cases of refractory holes. 108 – 110 …”

Section: Adjunctive Agents To Improve Closure Ratementioning

confidence: 99%

Optimal management of idiopathic macular holes

Madi¹,

Masri²,

Steel³

2016

OPTH

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This review evaluates the current surgical options for the management of idiopathic macular holes (IMHs), including vitrectomy, ocriplasmin (OCP), and expansile gas use, and discusses key background information to inform the choice of treatment. An evidence-based approach to selecting the best treatment option for the individual patient based on IMH characteristics and patient-specific factors is suggested. For holes without vitreomacular attachment (VMA), vitrectomy is the only option with three key surgical variables: whether to peel the inner limiting membrane (ILM), the type of tamponade agent to be used, and the requirement for postoperative face-down posturing. There is a general consensus that ILM peeling improves primary anatomical hole closure rate; however, in small holes (<250 µm), it is uncertain whether peeling is always required. It has been increasingly recognized that long-acting gas and face-down positioning are not always necessary in patients with small- and medium-sized holes, but large (>400 µm) and chronic holes (>1-year history) are usually treated with long-acting gas and posturing. Several studies on posturing and gas choice were carried out in combination with ILM peeling, which may also influence the gas and posturing requirement. Combined phacovitrectomy appears to offer more rapid visual recovery without affecting the long-term outcomes of vitrectomy for IMH. OCP is licensed for use in patients with small- or medium-sized holes and VMA. A greater success rate in using OCP has been reported in smaller holes, but further predictive factors for its success are needed to refine its use. It is important to counsel patients realistically regarding the rates of success with intravitreal OCP and its potential complications. Expansile gas can be considered as a further option in small holes with VMA; however, larger studies are required to provide guidance on its use.

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“…24 Anatomical closure was achieved in seven of seven cases reviewed. 24 Similar techniques using full-thickness macular incisions have been described by both Smiddy 26 and Charles 27 to address refractory macular holes.…”

Section: Discussionmentioning

confidence: 94%